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Dr. Osborne Talks to Men About BPH

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By: Spokesman Newsroom

BASSETERRE, St. Kitts (Thursday 5th June 2025)-During a recent appearance on Freedom FM’s ‘SKN Today’ with host Jamiella McPhail on Wednesday 4th June 2025, local medical practitioner Dr. Natalie Osborne addressed men’s health, focusing on the differences between Benign Prostatic Hyperplasia (BPH) and prostate cancer.

With June recognized as Men’s Health Month, Dr. Osborne emphasized the importance of education, regular screening and early detection.

“We’re going to give our men some love this month,” she said, adding, “…because knowledge is power, and we need our men to be healthier and live longer. Statistically, women outlive their partners-women typically outlive men-so we want to make some changes, and that starts with knowledge and prevention.”

BPH, she explained, is a non-cancerous enlargement of the prostate gland that affects a significant portion of aging men.

“The prostate gland enlarges above its normal size as time goes by, but there’s no cancer in it. That’s something we see a lot in older men. Think about this, gentlemen: by age 60, 50% of men will have some form of BPH. So if you have 100 men who are 60, half of them would have BPH.That’s a high percentage. By age 85, around 90% of men will experience signs and symptoms associated with BPH.”

Dr. Osborne informed that the symptoms of BPH and prostate cancer can be similar, but only proper screening can tell the difference.

She explained that the prostate sits just below the bladder and surrounds the urethra, the tube that carries urine.

“If the prostate enlarges, it presses on the urethra, reducing urine flow. You’ll notice men having to sit to urinate, dribbling afterward, and waking up multiple times at night.”

Highlighting how BPH impacts urinary function, she said:

“When men are younger and stronger, they can urinate with force-but as they get older, the flow weakens. Their wives will complain: ‘Honey, you’re messing up the seat’ or ‘You’re messing up the mat in front of the toilet’ because they’ve lost that strong aim. As a result, many older men choose to sit while urinating to avoid those issues.”

Frequent nighttime urination is another common symptom of BPH.

“They’re not emptying their bladder completely, so they always feel the need to go. The blockage causes a slow trickle of urine, and that sensation of fullness doesn’t go away. Sometimes they may experience blood in the urine, pain or develop a urinary tract infection.”

Left untreated, BPH can lead to more serious complications like urinary tract infections and even kidney damage.

Dr. Osborne pointed out that if the bladder is so blocked that urine can’t flow properly, it backs up into the kidneys. Such can cause damage to the kidney’s functional cells and potentially lead to kidney failure, dialysis, or the need for a transplant. Other symptoms may include pus-like discharge or foul-smelling urine.

Diagnosis of BPH begins with a symptom review and a digital rectal exam. Imaging tools such as ultrasound or MRI can be used to assess the size and structure of the prostate. Ultimately, a biopsy is required to confirm whether the condition is benign or cancerous.

When asked about treatment, Dr. Osborne outlined two main options: medical and surgical.

As gathered, medications can be used that block the hormone testosterone from converting to dihydrotestosterone which enlarges the prostate. It was also explained that if such is not effective, surgery may be necessary-either traditional open surgery or less invasive options like laser or steam treatment to remove the tissue causing the blockage.

On the topic of prostate cancer, Dr. Osborne noted that it is the most common cancer in men apart from skin cancer. Thirteen out of every 100 men will develop it at some point, and each year, around 34,000 men die from late-stage prostate cancer.”

She emphasized that prostate cancer often spreads to the bones, particularly the hips and pelvis, causing pain.

“That’s why screening is so important. After age 40, men should get their PSA checked every year. Early detection saves lives.”

She shared a real-life case involving a 78-year-old patient who visited her office concerned about a groin hernia. However, routine pre-surgical blood work revealed an abnormally high PSA level of over 100-well above the normal range of 0 to 4.

“I said, ‘Sir, this concerns me significantly,’ but he kept saying, ‘Doc, I just want the hernia fixed,’” she recalled.

Despite the patient’s focus on the hernia, Dr. Osborne insisted on further testing, and a subsequent biopsy confirmed prostate cancer.

“I had to push back a bit, because as a healthcare provider, you’re ultimately responsible for the patient when making decisions,” she explained.

That case, she said, highlights the importance of looking beyond the initial complaint and addressing broader health risks-especially among older Black men.

“What stood out to me is that you can’t just focus on what the patient wants to focus on. It’s important to work with your patient, and if something stands out, you have to address it,” she added.

Dr. Osborne also explained that PSA levels can rise for three main reasons: prostate cancer, BPH, and prostatitis-an inflammatory condition often seen in younger, sexually active men.

Again, she said the symptoms can overlap, so a biopsy is always needed to confirm whether it is cancer or a benign condition.

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