Benign Prostatic Hyperplasia – Causes, Symptoms, Diagnosis, And Treatment
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH) is enlargement of prostate gland. The prostate is a small gland located between kidneys and the penis. It surrounds urethra, a tubular structure through which urine passes out of the body. BPH means the gland grows bigger, but it is not cancer, and it does not increase the risk for prostate cancer. BPH happens to almost all men as they get older.
What causes benign prostatic hyperplasia?
The actual cause of BPH is not known to doctors. Doctors think aging and changes in the cells of the testicles may have a role in the growth of the gland, as well as testosterone levels.
The chance of developing BPH increases with age. It occurs commonly in almost all men who live long enough. It is observed that a small amount of prostate enlargement is present in most men over age 40. This condition occurs in more than 90% of men over age 80. No significant risk factors have been identified.
What are the symptoms of benign prostatic hyperplasia?
More than half of all men with BPH don’t have symptoms. This means symptoms occur in less than half of all men with BPH.
The following are the common symptoms:
- urinary retention
- Incomplete emptying of your bladder
- Post-void dribbling
- Urge to urinate more than 2 times per night
- Pain with urination
- Blood in the urine
- Delayed start of the urinary stream
- Weak urine stream
- Straining to urinate
- Strong and sudden urinary urge
How is benign prostatic hyperplasia diagnosed?
Your doctor will review your medical history and symptoms and will perform a digital rectal exam to feel the prostate gland.
The doctor may order the following tests:
- Post-void residual urine test (to measure quantity of urine left in the bladder after urination)
- Urine flow rate
- Pressure-flow studies (to measure the bladder pressure while urination)
- Urinalysis (to check for infection or blood)
- Urine culture
- PSA (prostate-specific antigen) test to screen for prostate cancer
- Blood urea nitrogen (BUN) and creatinine tests
How is benign prostatic hyperplasia treated?
The treatment depends on the severity of your symptoms, how much they bother you, and your medical condition. Generally, treatment comprises of watchful waiting, lifestyle changes, medicines, or surgery.
For men with only minor symptoms, self-care steps are often enough to make them feel better.
The following self-care measures can help feel better:
- Urinate when you first get the urge.
- Go to the bathroom on a timed schedule, even if you don’t feel a need to urinate.
- Avoid alcohol and caffeine, especially after dinner.
- Avoid drinking a lot of fluids at a single time. Instead, spread out intake of fluids during the day. Avoid drinking fluids 2 hours before bedtime.
- Avoid taking over-the-counter cold and sinus medicines containing decongestants or antihistamines, as these medicines may increase BPH symptoms.
- Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
- Perform Kegel exerciseson a regular basis.
- Reduce stress. Nervousness and tension can lead to more frequent urination.
The doctor may recommend prostate surgery if you have:
- Symptoms that don’t improve with medicines
- Recurrent blood in the urine
- Urinary retention
- Recurrent urinary tract infections
- Decreasing kidney function
- Bladder stones
Different types of surgical procedures are available to treat BPH. Your doctor will recommend the choice of surgical procedure based on the severity of your symptoms and the size and shape of your prostate gland. Urine flow rate and symptoms improve in most men after prostate surgery.
The following are the commonly recommended surgical choices:
- Transurethral resection of the prostate (TURP): This procedure is the most used, as it is effective and proven surgical treatment for BPH.
- Simple prostatectomy: This procedure is generally done when the prostate gland is very large. It involves open surgery to remove the inside part of the prostate gland.
Other less-invasive procedures are also available to treat BPH. These procedures are recommended for people with severe medical conditions, such as uncontrolled diabetes, cirrhosis, alcoholism, psychosis, and serious lung, kidney, or heart disease. These less invasive procedures are also recommended for people who are taking blood-thinning medicines and people with high surgical risk.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.