Tetra said:
Wait, there are people who don’t have it ?
ROTFL…
Yes - this is really very common in men - probably about 40% of those over 50 have this condition. However, this does not mean that all of them have symptoms.
Basically, there are three phases of BPH:
In the first, you don't notice much - except that you have to go out more often at night and your urine stream is not as strong.
In the second phase, you may experience urinary retention, higher residual urine and other LUTS effects.
Tetra has already described the third phase. This ends - if not operated on first - with bladder hypertrophy and overflow incontinence.
The indication for surgery is urinary retention. The aim is always to protect the kidneys. During surgery, the prostate is scraped out - unfortunately, even with the most modern methods such as green laser or Davici, in some cases (5 - 10%) this leads to subsequent stress incontinence and / or impotence.
In BPH, urge problems can also occur in the first two phases. The reason for this is that the prostate presses on the lower bladder nerves. First approach is actually always tamsulusin. If you are lucky, the tamsulusin will make the prostate not press so hard on the lower bladder nerves and the urge problem will be reduced. If not, treatment is the same as for "normal" urge incontinence - with a higher risk of urinary retention with drug treatment. This is because as the obstruction progresses, the bladder has to exert more and more force against the resistance. If it is then dampened with botox, for example, it may no longer be able to do this and ISK is the result.
There is no real therapy against BPH as far as I know. The "standard treatment" is "controlled waiting". This means that the doctor regularly checks the residual urine with ultrasound and if it becomes too much or other LUTS occur, they try to mitigate the effect. As far as I know, there is no drug that _proven_ to reduce the size of the prostate again.