As men age, their prostates grow, often leading to benign prostatic hyperplasia (BPH). Although this disease — common in aging societies — can have troubling symptoms, it is not always a cause for distress. A recent article published by Harvard researchers looked at BPH, with discussion ranging from its risk factors and overall medical costs to treatment approaches. The paper, titled “Benign prostatic hyperplasia: epidemiology, economics and evaluation“ appeared in October in the Canadian Journal of Urology.
Several risk factors for BPH have been identified, though it is not clear how these factors impact BPH. For example, being Jewish increases BPH risk, the researchers said in their discussion. Religious background may correspond to genetic factors, due to marriage within the religion restricting genetic variability, or to cultural factors, such as seeking out more medical care. Higher income is also associated with a greater BPH risk, which again may have to do with higher incidence of reporting and diagnosis. Hypertension is not associated with BPH, although inflammatory conditions in general appear to increase its risk, as do obesity and diabetes.
Physical activity, not surprisingly, seems to decreases the likelihood of developing this condition.
Although BPH is a somewhat benign condition, it still requires treatment and therefore often comes with high costs. Treating BPH costs about $4 billion annually in the United States. Disease diagnosis costs can include those associated with a clinical exam, an analysis of urinary problems along with measurement of serum prostate antigen (PSA) levels. Treatments, of course, also impact the medical cost of BPH.
Healthcare providers will select treatments based on the severity of symptoms: while men with only mild symptoms do not require further treatment, those with more troubling symptoms can be treated either medically or surgically. The authors further highlight that currently, six classes of medications are available to treat BPH, with surgical procedures including laproscopic, laser, and open and robotic techniques.
Lifestyle modifications can also help in the management of BPH, including weight loss, decreasing fluid intake in the evening, cutting down on alcohol and caffeine, changing the time at which medications are taken, and quitting smoking.
Overall, BPH is a common and manageable medical condition that is being treated more often in primary care. According to researchers, urologists and primary care physicians should work together as a team to help treat BPH. Moreover, better education about the condition and its treatments is necessary, and routine inquiry about urinary function in men over 50 should ideally be a standard practice for primary care practitioners.