What Is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH), also called an enlarged prostate, is a condition that causes problems with urination. “While not usually dangerous, it can impact your quality of life,” says Dr. Milan Shah, a University Health urologist.
BPH becomes more common with age and does not usually affect men younger than 40. The prostate is a small gland right below the bladder that helps produce semen, and it tends to get larger the older you get.
An enlarged prostate is a normal part of aging and does not raise your risk for prostate cancer. Studies suggest about 70% of men between the ages of 60-70 experience benign prostatic hyperplasia.
Symptoms of BPH
The prostate gland is located directly below the bladder and surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets larger, particularly the median lobe, it can obstruct the urethra, leading to urinary problems.
Common symptoms include, but are not limited to:
- Frequent urination (peeing)
- Increased need to urinate at night
- Weak urination stream
- Difficulty starting to pee
- Feeling like you can’t fully empty your bladder
Causes of BPH
Dr. Shah says the prostate tends to steadily grow throughout a man’s life, but symptoms may present at different ages, if at all. Some factors may put you at a higher risk for an enlarged prostate sooner, including:
- Obesity
- Family history of BPH
- Physical inactivity
- Erectile dysfunction
- Type 2 diabetes
How to Diagnose BPH
If you have symptoms of BPH, your doctor will discuss your health history and may perform a basic physical exam. Additionally, they may do other tests, including:
- Urine test
- Digital rectal exam
- Post-void residual volume (PVR)
- Urine flow study
- UroCuff
- PSA (prostate-specific antigen) blood test
- Renal ultrasound
- Flexible cystoscopy
BPH Treatments at University Health
Your doctor will recommend a treatment plan based on your symptoms, age, health history and goals. “Depending on the severity of your symptoms, you may have several treatment options, including lifestyle changes, medication and surgery,” says Dr. Shah.
Lifestyle Changes and Observation
If your symptoms are mild, your provider may recommend simple lifestyle changes and watchful waiting to see if your symptoms improve. They may recommend:
- Losing excess weight
- Reducing caffeine intake because caffeine is a diuretic
- Pelvic floor exercises
- Restricting liquid intake before bed
Medication
Your doctor can prescribe medications that can reduce the size of the prostate and relax the prostate or bladder smooth muscle without need for surgery. This may improve your urinary symptoms. Some of these medications can also help treat erectile dysfunction.
Some examples of these medications include:
- Alpha-blockers
- Tadalafil
- Five alpha-reductase inhibitors
- Antimuscarinics
Your doctor will discuss a medication plan that right for you.
Surgery
Surgical intervention may be the best option for those who do not respond to lifestyle changes or medication. It is also recommended for those who experience recurring urinary infections, bladder stones and renal failure. Your doctor will thoroughly consider all factors to ensure that surgery is the best option for you.
Transurethral Resection of the Prostate
A transurethral resection of the prostate (TURP) is a common surgical procedure used primarily to treat urinary problems caused by an enlarged prostate. Your doctor will perform diagnostic testing before proceeding with a TURP, including but not limited to:
- Cystoscopy
- Transrectal ultrasound
- UroCuff
- Post-void residual volume (PVR)
Some patients may need to stay in the hospital after a TURP for continuous irrigation of the bladder, which involves flushing the bladder with sterile solution through a catheter. However, University Health can offer an outpatient TURP with no continuous bladder irrigation for many of our patients. This reduces the amount of time spent in the hospital.
Learn more about University Health urology care online.
