Benign prostatic hyperplasia (BPH)
Non-cancerous enlargement of the prostate. Common after age 50 — half of men in their 60s and 80% by 80. Causes lower-urinary-tract symptoms (frequency, weak stream, nocturia); rarely life-threatening but quality-of-life-impairing.
What it is
BPH is the non-malignant proliferation of glandular and stromal tissue in the transition zone of the prostate. Driven by lifelong androgen exposure (chiefly dihydrotestosterone), the prostate squeezes the urethra it surrounds, causing 'lower urinary tract symptoms' (LUTS) — frequency, urgency, nocturia, weak stream, incomplete emptying, post-void dribble. About 50% of men in their 60s and 80% by their 80s have histological BPH; perhaps half of those have clinically significant LUTS. Complications include UTIs, bladder stones, acute urinary retention (a urological emergency), and obstructive uropathy with kidney injury.
Key lab markers
- PSA — typically mildly raised by the larger prostate volume; values 4–10 ng/mL are the 'grey zone' where cancer cannot be excluded without further workup.
- Creatinine, eGFR — kidney function; obstructive uropathy from severe BPH can cause renal injury (hydronephrosis).
- Urinalysis — to exclude UTI, microhaematuria.
- International Prostate Symptom Score (IPSS) — clinical questionnaire, not lab.
- Post-void residual ultrasound — gauges severity.
Symptoms
- Urinary frequency, urgency
- Nocturia (waking ≥2 times to urinate)
- Weak / hesitant stream, straining to start
- Incomplete bladder emptying, post-void dribbling
- Acute urinary retention (medical emergency)
- Recurrent UTIs
When to discuss with a doctor
LUTS warrants a primary-care visit to score the bothersomeness (IPSS), exclude UTI, screen PSA and creatinine. First-line treatment is lifestyle (reduce evening fluids, caffeine, alcohol) plus an alpha-blocker (e.g. tamsulosin) for symptoms or a 5-alpha-reductase inhibitor (finasteride, dutasteride) for shrinkage in larger glands. Surgery (TURP, laser) for refractory or complicated cases. Acute urinary retention is an emergency. Mediora.AI flags the PSA against age and the kidney function panel; the LUTS workup belongs with a GP or urologist.