Benign Prostatic Hyperplasia
What is it?
Benign prostatic hyperplasia (BPH) is a noncancerous growth of the prostate gland. This small, chestnut-shaped gland surrounds the urethra (the tube from the bladder to the opening in the penis) where it emerges from the bladder. The prostate produces a fluid that nourishes sperm and is ejaculated during orgasm. BPH does not increase a man’s risk of developing prostate cancer. However, a man can have prostate cancer and BPH at the same time.
Who gets it?
BPH is a common health problem in men over the age of 60.
What causes it?
The cause of BPH is not known, but may be related to changes in hormone levels that naturally occur as a man ages.
What are the symptoms?
Initial symptoms of BPH include difficulty starting to urinate and a feeling of incomplete urination. As the prostate gland grows larger, it presses upon the urethra and narrows it. This blocks the flow of urine. The bladder begins pushing harder to get the urine through, which causes the bladder muscles to become larger and more sensitive. This, as well as the fact that the bladder can never fully empty, causes a feeling of needing to urinate frequently. Other symptoms include a weak stream of urine, dribbling of urine right after urinating, the need to urinate at night more frequently. If the bladder ends up overfilled, you may experience leaking of urine, or incontinence. Some men will have repeated urinary tract infections and kidney stones. Urinary tract infections cause burning or pain during urination, and possibly fever. Blood can appear in the urine if you strain to urinate, which can cause small veins in the urethra and bladder to burst.
How is it diagnosed?
Your doctor can feel an enlarged prostate through a rectal exam. He or she will check your medical history and also ask questions about any symptoms you may be experiencing. You will need to provide a urine specimen, which will be examined for signs of infection. Your doctor will order a blood test that checks your prostate-specific antigen (PSA) levels. Men with BPH will have elevated levels of PSA. If your PSA levels are high, your doctor will want to perform additional tests to rule out prostate cancer. You may be referred to a urologist, a doctor who speciliazes in the urinary tract, for further tests.
What is the treatment?
Mild BPH is monitored by frequent exams. If your symptoms are moderate, your doctor may recommend treatment with alpha blockers, such as
terazosin, prazosin, or doxazosin. Alpha blockers relax the muscles at the bladder outlet. Or, drugs such as finasteride work to shrink the prostate and delay the need for surgery. Relief of symptoms with finasteride may take three months or longer. A catheter may be needed if the urine flow becomes completely blocked. Urinary infections are treated with antibiotics. Some cases require surgery for relief of symptoms. The most common procedure is transurethral resection of the prostate
(TURP). In this procedure, the surgeon inserts an
endoscope, which is a long, thin tube equipped with a camera, up the urethra. He or she then removes part of the prostate. No surgical incision is needed. The endoscope can also be equipped with a laser to burn away some of the prostate tissue. Another surgical procedure called transurethral incision of the prostate
(TUIP) is sometimes recommended, but is not as effective as
TURP. In this procedure, the surgeon makes one or two small cuts in the prostate, which reduce the prostate’s pressure on the urethra. Additional treatments for BPH are being studied. You and your doctor should discuss all the options and decide which one is best for you.
Self-care tips
There is currently no known way to prevent BPH. If you have been diagnosed with
BPH, follow your doctor’s orders for care and treatment. As with any illness, early detection is important.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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