taken from Small Gland, Big Problem 4th Edition
by Professor Roger Kirby, Health Press 2011
Nearly half of men over the age of 65 have either urinary symptoms or a reduced urinary flow due to benign prostatic hyperplasia (BPH). BPH is characterized by the benign (non-cancerous) overgrowth of prostate cells, with the effect that the central portion of the prostate progressively enlarges. The result is that the part of the urethra that is surrounded by the prostate becomes constricted. This reduces the urinary flow and the man finds that his urine stream becomes weaker and it is more difficult to empty his bladder. These symptoms may significantly impair quality of life.
In response to the increasing obstruction, the muscular bladder wall thickens and becomes stronger. Consequently, the pressure inside the bladder needed to produce urinary flow has to increase to overcome the effect of the obstruction; this high pressure causes pouches or ‘diverticula’ to form. Less commonly, the raised pressure results in what is known as ‘back pressure’ on the kidneys, causing kidney problems. If BPH is not treated, either chronic urinary retention (characterized by a massively over-distended bladder) or acute urinary retention (the sudden inability to pass any urine, with painful overdistension of the bladder) may develop. In either situation, hospital admission, catheterization and, often, prostate surgery are usually required.