While age has always been the strongest risk factor for benign prostatic hyperplasia (BPH), ethnicity and lifestyle factors also play a big role in its onset. While explaining healthy habits that can prevent early onset of the disease, Dr Vineeth Adiyodi, senior consultatnt urologist at Malabar Hospitals, Kozhikode, says people should drink more water during the day and reduce fluid intake in the evenings, in an interview with Affan Abdul Kadar. Edited excerpts:
What are the symptoms of Benign Prostatic Hyperplasia?
Common symptoms include frequent urination, especially at night (getting up 2–3 times or more), weak urine flow or urine taking longer to start, feeling of incomplete emptying after urinating, urgency or sudden strong need to pass urine, dribbling at the end of urination, and straining to pass urine. In Kerala, many men think it’s age-related bladder weakness, but it is often due to prostate enlargement.
Who is at most risk of developing BPH?
Age is the strongest non-modifiable risk factor. The prevalence of BPH (histologically) rises sharply with age. Observational studies (cited by EAU) show that older men have increased prostate size, more lower urinary tract symptoms (LUTS), and higher risk of progression.
Another factor is family history as genetic predisposition (family history) contributes significantly.
Components of metabolic syndrome (e.g., insulin resistance, central obesity, dyslipidaemia) are also strongly associated with BPH risk and prostate enlargement.
Hormonal imbalance also plays a role as androgens (especially dihydrotestosterone, DHT) play a permissive role as BPH development requires androgen signalling. Chronic inflammation in prostate tissue is also considered a contributing factor.
Geography (ethnicity) may also influence risk, as some studies suggest different prevalence / progression in different populations.
Lifestyle factors: While not always listed as “guideline risk factors,” supporting evidence suggests physical inactivity is linked to higher BPH risk. Unhealthy diet (high fat, possibly low in protective nutrients) and smoking/alcohol may also contribute to the risks.
If the condition is left untreated, what complications may arise?
If the condition is ignored, it can lead to acute urinary retention (sudden inability to pass urine; requires emergency catheter), repeated urinary infections, bladder damage due to overwork, formation of bladder stones, and kidney damage in severe, long-standing cases.
Do lifestyle factors affect the onset of BPH?
Lifestyle contributes significantly to the onset of the disease. Excess caffeine (tea/coffee) (very common in Kerala), consumption of alcohol, low physical activity, diets high in calories and oily, and drinking less water during the day and more at night can advance the onset of BPH.
Some healthy habits that can prevent BPH include restricting intake of fluids in the evening, cutting down tea/coffee after 6pm, walking regularly and weight control. Besides, patients with diabetes and hypertension should manage their condition well.
What are the treatment options available and how much will it cost?
Treatment options include both medications and surgery. Medications include alpha-blockers to improve urine flow and reduce symptoms, 5-alpha reductase inhibitors to shrink the prostate over time, and combination therapy of both these medicines. The approximate treatment cost with medicines would be `700-`1,300per month .Most patients may need continuous treatment.
Minimally invasive options include TURP (transurethral resection of prostate), laser prostate surgery (less bleeding, faster recovery), UroLift (using tiny implants to lift prostate tissue away from the urethra for quicker relief) and Rezum (using steam to shrink excess tissue, offering gradual improvement, potentially treating larger prostates or middle lobes. The best choice depends on prostate size, symptoms, and patient preference for immediate vs. gradual results, with UroLift often faster but Rezum potentially better for certain prostate shapes.
The approximate cost for minimal invasive options varies between Rs 60,000 and Rs 1.8 lakh.
