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What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH) is a condition that affects the prostate gland in men. “Hyperplasia” means enlargement. “Benign” means the enlargement isn’t caused by cancer or infection.
The prostate helps make semen. It is found between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly grows bigger. As it gets bigger, it may press on the urethra. This can cause the flow of urine to be slower and less forceful.
Symptoms of BPH
Most symptoms of BPH start gradually. They include:
- The need to get up more often at night to urinate.
- The need to empty the bladder often during the day.
- Difficulty in starting the urine flow
- Dribbling after urination ends.
- Decrease in the size and strength of the urine stream.
- Incontinence, or lack of control over urination.
These symptoms can be caused by other things besides BPH. They may be signs of more serious diseases, such as a bladder infection or bladder cancer. Tell your doctor if you have any of these symptoms. He or she can decide which tests to use to find the possible cause.
What causes BPH?
The exact cause of BPH isn’t well understood. It appears to be related to aging. About 50% of men over age 50 have BPH. Up to 90% of men older than 80 have it.
The following factors could increase your risk of BPH:
- age 40 or older
- family history of BPH
- being obese
- heart and circulatory disease
- type 2 diabetes
- lack of exercise
- erectile dysfunction.
How is BPH diagnosed?
Your doctor will take a complete history of your symptoms. Then he or she will do a rectal exam to check your prostate. They will put a gloved, lubricated finger into your rectum to feel the size of your prostate gland.
To make sure that your prostate problem is benign, your doctor may do other tests. He or she may test your urine for signs of infection. They may do a blood test. An ultrasound exam or a biopsy of the prostate may also help them make a diagnosis.
Can BPH be prevented or avoided?
There is nothing you can do to prevent or avoid BPH. Recent studies have shown that increasing physical activity may help. It can lower the frequency of BPH symptoms. Talk to your doctor to see if an activity or exercise plan is right for you.
Treatment for BPH depends on what symptoms you have and how severe they are. Options include lifestyle changes, medicine, minimally invasive procedures, and surgery.
If your symptoms are mild or only slightly bothersome, you can usually control them with simple changes. These include:
- Reducing liquid intake, especially before going to bed or going out in public.
- Avoiding caffeine, alcohol, and over-the-counter medicines that make you urinate more.
- Training your bladder to hold urine longer.
- Exercising your pelvic floor muscles.
- Preventing constipation.
Your doctor can prescribe different medicines to treat BPH. Some of these reduce the symptoms by improving urine flow or reducing blockages in the bladder. Others stop the growth of or shrink the prostate. Sometimes a combination of different medicines is used. Your doctor will recommend medicine based on your symptoms and condition.
Minimally invasive procedures
Minimally invasive treatment does not involve surgery. Most of these treatments use heat to destroy prostate tissue that is pressing on the urethra. They can usually be done by your doctor in his or her office. Most are done by inserting a catheter (a thin, flexible tube) through the urethra to reach the prostate. These treatments may require local, regional, or general anesthesia.
These treatments relieve symptoms of BPH. They do not cure it. Your doctor will consider your symptoms and overall health when deciding what procedure you should have.
Surgery is considered the most effective treatment for BPH. It is used in men who have strong symptoms that persist after trying other treatments. This is also the best way to diagnose and cure early cancer of the prostate. Surgery is usually done through the urethra, leaving no scars. Surgery does have risks, such as bleeding, infection or impotence. These risks are generally small.
Living with BPH
BPH is not life-threatening, but it can be bothersome. There are also some complications that can occur. These include:
- inability to urinate
- blood in the urine
- urinary tract infections
- bladder or kidney damage
- bladder stones.
Sometimes men have urinary symptoms that are not related to BPH. They could be the signs of a more serious condition, including prostate cancer. See your doctor right away f you notice any of the following symptoms:
- complete inability to urinate
- painful, urgent, and frequent need to urinate
- blood in your urine
- pain in the lower abdomen and/or urinary tract
- fever or chills along with any of the above symptoms.
Questions to ask your doctor
- How long will my treatment last?
- Is surgery an option?
- Will there be any side effects from my treatment?
- Does this mean I am at higher risk of developing prostate cancer?
- Is there anything I can do to make urinating easier?
- Could my symptoms be caused by something other than BPH?
- Will there be any sexual side effects of my treatment?