Benign Prostatic Hyperplasia (BPH)

Last Updated May 2022 | This article was created by familydoctor.org editorial staff and reviewed by Kyle Bradford Jones

What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is the medical term for an enlarged prostate. The condition affects the prostate gland in men. The enlargement isn’t caused by cancer or infection.

The prostate makes semen. It is located between the bladder (where urine is stored) and the urethra (the tube urine passes through). As men age, the prostate gland slowly gets bigger. As it gets bigger, it may press on the urethra. This can cause a slower, weaker urine stream.

Symptoms of BPH

Most symptoms of BPH start gradually. They include:

  • Getting up more often at night to urinate
  • Having 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 difficulty controlling 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. They can decide which tests to use to find the possible cause.

Severe BPH without treatment can lead to bladder and kidney infections.

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
  • Obesity
  • Heart and circulatory disease
  • Type 2 diabetes
  • Inactivity
  • Erectile dysfunction

Changing male hormone levels as a man ages may also be to blame.

How is BPH diagnosed?

Your doctor will ask you about your symptoms. They will do a rectal exam to check your prostate. For this, your doctor will put a gloved, lubricated finger into your rectum. They will feel the size of your prostate gland.

Your doctor may do blood or urine tests to make sure that your prostate problem is benign. An ultrasound exam or a biopsy of the prostate may also help in the  diagnosis.

Can BPH be prevented or avoided?

There is nothing you can do to prevent or avoid BPH. Exercise, controlling your type 2 diabetes, and losing weight may reduce your risk of BPH.

BPH treatment

Treatment for BPH depends on what symptoms you have and how severe they are. Options include lifestyle changes, medicine, minimally invasive procedures, and surgery.

Lifestyle changes

If your symptoms are mild or only slightly bothersome, you can usually control them with simple changes. These include:

  • Reduce liquid intake, especially before bed or going out in public.
  • Avoid caffeine, alcohol, and over-the-counter medicines that make you urinate more.
  • Train your bladder to hold urine longer.
  • Exercise your pelvic floor muscles.
  • Prevent constipation.

Medicine

Your doctor can prescribe different medicines to treat BPH. Some of these improve urine flow or reduce blockages in the bladder. Others stop or shrink the growth of 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. These treatments use heat to destroy prostate tissue that is pressing on the urethra. They can usually be done in the doctor’s office. This is 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. They do not cure BPH. Your doctor will consider your symptoms and overall health when deciding what procedure you should have.

Surgery

Surgery is the most effective treatment for BPH. It is a last resort when other treatments fail. 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. These include bleeding, infection or impotence. 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
  • Incontinence
  • Blood in the urine
  • Urinary tract infections
  • Bladder or kidney damage
  • Bladder stones

Some 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 if 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?
  • 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?