BPH: Addressing 7 Common Misconceptions

Benign prostatic hyperplasia (BPH) is a common condition that occurs due to the gradual enlargement of the prostate gland. This enlargement can exert pressure on the urethra and bladder outlet, leading to various urinary symptoms such as frequent urination, urgency, incontinence, increased nighttime urination, difficulty starting urination, intermittent flow, incomplete emptying, and post-void dribbling.

Despite the prevalence of BPH, there are several misconceptions surrounding this condition that patients should be aware of:

Misconception 1: Urinary Symptoms Automatically Indicate BPH

While BPH can manifest in urinary frequency, urgency, and difficulty urinating, these symptoms can also be caused by other conditions, including chronic prostatitis, urinary tract infections, neurogenic bladder, diabetic bladder dysfunction, renal insufficiency, bladder overactivity, urethral stricture, primary bladder neck obstruction, bladder neck spasm, and detrusor-sphincter dyssynergia. Therefore, the presence of these urinary symptoms does not necessarily equate to benign prostatic hyperplasia.

Misconception 2: BPH is Solely Due to Kidney Deficiency

In traditional Chinese medicine, some believe that BPH is caused by a "kidney deficiency" and self-medicate with "kidney-tonifying" medications. However, the underlying causes of BPH can be more complex, including qi stagnation and blood stasis due to liver qi stagnation, or damp-heat accumulation from factors like poor diet and alcohol consumption. Individualized treatment using traditional Chinese medicine should be tailored to the patient's specific condition rather than a one-size-fits-all approach.

Misconception 3: Popular Prostate Treatment Devices are Reliable

Many devices on the market claim to treat BPH, but the majority of these have little to no proven efficacy in controlling prostate enlargement or reducing its size.

Misconception 4: BPH Severity is Directly Linked to Prostate Size

Many men may be familiar with this condition, but some may be confused by the terminology. They often hear doctors say that a normal prostate is about the size of a chestnut, so enlargement essentially means an increase in size. Therefore, does this disease imply severe enlargement?

However, in reality, these are two different matters. Clinically, the severity of manifestations in many men is not necessarily correlated with the size.

Among men with BPH, there are two distinct situations: internal enlargement, which may compress the urethra passing through it, leading to urinary obstruction; and external enlargement, where urinary signs appear relatively late. Since the prostate is closely adjacent to the rectum, external enlargement may also lead to constipation.

Hence, one should not assume that BPH and the severity of symptoms are directly related; it's also essential to consider the direction of enlargement and its effects.

Misconception 5: Stopping Medication Once Symptoms Improve

BPH is a chronic condition that requires long-term medication adherence. Stopping medication without medical advice can lead to a rebound or worsening of symptoms, and a follow-up is necessary to ensure the prostate has returned to a normal size.

Misconception 6: Switching Medications Immediately if Symptoms Don't Improve

Different BPH medications have varying onset times, so it's not advisable to switch medications immediately if symptoms don't improve significantly after a short period of use. Frequent medication changes can also lead to adverse drug reactions.

Misconception 7: BPH Develops into Prostate Cancer

While the incidence of prostate cancer has been increasing, there is no direct relationship between BPH and prostate cancer. BPH is a benign proliferative disease, and it does not rapidly develop or worsen in the short term. However, regular prostate-specific antigen (PSA) testing is still recommended to rule out the possibility of prostate cancer.

By addressing these common misconceptions, patients can better understand the nature of benign prostatic hyperplasia and work closely with their healthcare providers to manage this condition effectively.