Benign Prostatic Hyperplasia (BPH)

BPH

Benign Prostatic Hyperplasia (BPH) is an enlargement of the prostate which involves hormones, not just prostate cells. The hormones affect various types of tissues, including glandular and muscular tissues, which affect men differently.

Because of the different affects on men, treatment options for BPH vary by individual depending on the best outcome for your response. Once BPH has begun, it will continue in many cases unless therapy is started. There is no cure for BPH.

About

As a man gets older, it’s common for the prostate to grow bigger and obstruct the flow of urine or interfere with sexual function. This condition is called benign prostate hyperplasia (BPH) and may require treatment with medicine or surgery. BPH is not cancer, but can cause many of the same symptoms as prostate cancer. You should always seek the advice of your healthcare provider.

There are 2 different ways that your prostate grows:

  1. A multiplication of cells around your man’s urethra, resulting in a ‘squeezing’ effect.
  2. Middle-lobe prostate growth where cells grow into the man’s urethra and bladder outlet often requiring a surgical procedure.

FYI

There are 3 factors that increase your risk of developing BPH:

  • Age: Starting at age 45, the risk of developing BPH increases.
  • Family history: If any immediate blood relative was diagnosed with BPH, you are more likely to develop the condition.
  • Some research indicates that medical conditions such as obesity may contribute to the development of BPH.

There is no connection between BPH and cancer. However, if left untreated, the condition can cause bladder infections and kidney stones, and in some cases, permanent bladder and/or kidney damage.

Symptoms

Half of men between the ages of 50 and 60 will develop BPH, and by the age of 70 or 80, about 90% will have experienced BPH symptoms, which may include:

  • Frequent, often-urgent need to urinate, especially at night
  • Need to strain or push to get the urine flowing
  • Inability to completely empty the bladder
  • Dribbling or leaking after urination
  • Weak urine stream

Because male urinary symptoms can also herald more serious conditions, such as prostate cancer, it’s important to see your health care provider to determine the cause of your symptoms. BPH symptoms vary with the individual. Since the prostate gland continues to grow in many older men, the symptoms may worsen with time and those who suffer from the condition may find it interferes with sexual function.

Diagnosis

The risk of developing BPH symptoms can almost be eliminated by diagnosing the condition early.  Your health care provider may order tests to measure how quickly urine flows from the bladder, or do ultrasound or x-ray examinations of the bladder, kidneys, urethra and prostate. He may order a PSA (prostate specific antigen) test. This blood test is often used to diagnose and monitor BPH and to help rule out prostate cancer.

For more information on the PSA test, see the prostate cancer section.

Questions to Ask Your Health Care Provider

It’s important that you become proactive in your healthcare in order for you to get the best treatment. Here are some questions you can ask your healthcare provider about BPH.

  1. What are the best treatment options for me?
  2. Is surgery an option?
  3. Will there be any side effects from my treatment?
  4. Does this mean I am at higher risk of developing prostate cancer?
  5. Is there anything I can do to make urinating easier?
  6. Could my symptoms be caused by something other than BPH?
  7. Will there be any sexual side effects of my treatment?

Treatments

If you are diagnosed with BPH, your healthcare provider has a number of options to choose from.

Active Surveillance

This means keeping an eye on your BPH symptoms without receiving any form of treatment. For men with minimal to mild BPH symptoms which do not interfere with daily routines, this may be a preferred choice. Annual exams also contribute to the active surveillance.

Medications

Drugs called alpha-blockers are the most common treatment prescribed to manage BPH symptoms. By relaxing the muscles around the prostate so that there is less pressure on the urethra, alpha-blockers work quickly to improve urinary flow. Common side effects can include stomach or intestinal problems, a stuffy nose, headache, dizziness, tiredness, a drop in blood pressure and ejaculatory problems.

No matter what kind of treatment is prescribed, patients and healthcare providers need to be aware of potential drug interactions with treatments used to manage other conditions common among aging men, such as erectile dysfunction and hypertension.

Surgical Treatments

Surgery is typically used only in those patients with major BPH complications such as frequent urinary tract infections or bladder stones. There are several non-surgical approaches that use heat therapy to reduce the size of the prostate, thereby widening the urethra. These heat treatments include microwave therapy, radiofrequency therapy, electrovaporization and laser therapy. In the most extreme cases, open surgery may be required. Surgery treats BPH symptoms by reducing the size of the prostate, but it does not prevent the cause of the disorder. This means that surgery might need to be repeated within a few years. Side effects of surgery may include urgency and frequency of urination for some period after the event, difficulty in achieving an erection, blood in your urine, inability to hold your urine (incontinence) or a narrowing of the urethra (scarring).

Resources

For More Information on Benign Prostatic Hyperplasia Visit: 

NIDDK
Urology Care Foundation

Last modified: May 30, 2014