Benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems. The cause is unclear. Risk factors include a family history, obesity, type 2 diabetes, not enough exercise, and erectile dysfunction. Medications like pseudoephedrine, anticholinergics, and calcium channel blockers may worsen symptoms. The underlying mechanism involves the prostate pressing on the urethra thereby making it difficult to pass urine out of the bladder. Diagnosis is typically based on symptoms and examination after ruling out other possible causes. Treatment options include lifestyle changes, medications, a number of procedures, and surgery. In those with mild symptoms, weight loss, decreasing caffeine intake, and exercise are recommended, although the quality of the evidence for exercise is low. In those with more significant symptoms, medications may include alpha blockers such as terazosin or 5α-reductase inhibitors such as finasteride. Surgical removal of part of the prostate may be carried out in those who do not improve with other measures. Some studies have suggested that certain plant extracts may help mitigate symptoms of BPH. Examples include saw palmetto (Serenoa repens), stinging nettle (Urtica dioica) root, beta-sitosterol from African star grass (Hypoxis rooperi), and pygeum (extracted from the bark of Prunus africana). However, meta-analyses have called these conclusions into question, highlighting methodological problems showing no difference from a placebo, and lack of support from larger scale trials. As of 2019, about 94 million men aged 40 years and older are affected globally. BPH typically begins after the age of 40. The prevalence of clinically diagnosed BPH peaks at 24% in men aged 75–79 years. Based on autopsy studies, half of...