Benign Prostatic Hyperplasia

  • Definition

    Benign Prostatic Hyperplasia (BPH) is an enlarged prostate gland. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. BPH occurs in most men as they age. About half of all men over the age of 75 experience symptoms.

    BPH causes the following problems:

    • Trouble getting a urine stream started
    • The need to urinate
    • A weak urine stream
    • A sense that you haven’t emptied your bladder
  • Symptoms

    Many men with BPH have no symptoms and when symptoms do occur they are often mild. Symptoms may become worse during cold weather, while taking certain medications, or during times of physical and emotional stress.

    Symptoms may involve problems either emptying the bladder or with bladder storage.

    Symptoms related to bladder emptying include:

    • Trouble getting a urine stream started
    • Weak urine flow
    • Dribbling after urination
    • A sense that you haven’t emptied your bladder
    • Frequent urination
    • Pain during urination

    Symptoms related to bladder storage include:

    • Waking at night to urinate
    • Frequent urination
    • A sudden and uncontrollable urge to urinate
  • Causes

    BPH is a normal part of the aging process in men. It is frequently caused by changes in hormone balance, though genetics can play a part.

  • Risk factors

    Men over the age of 50 are at a higher risk for BPH. A family history of BPH may increase your need for treatment of BPH.

  • Tests and diagnosis

    Your doctor will want to make sure that your urination problem is caused by BPH and not by something else. This can be determined by reviewing your medical history, a physical exam, a urinalysis and a blood tests.

    The following tests are often done:

    • A digital rectal exam to check the size and firmness of your prostate
    • A urinalysis and urine culture to check for a possible urinary tract infection
    • A prostate-specific antigen test to check for prostate cancer, which can sometimes cause the symptoms of BPH.

    If your symptoms are moderate to severe the following tests or studies may be done:

    • A blood creatinine test to check your kidney function
    • Post-void residual urine test to measure the amount of urine left in your bladder after urination
    • Pressure flow studies to measure the pressure in your bladder while urinating
    • Cystometrogram, which measures the bladder’s pressure, compliance and even capacity to hold urine

    Your doctor may also use an ultrasound, X-ray or even CT scan to look at your bladder. This is generally only done if there is a need to look for other causes of your BPH symptoms.

  • Treatment and drugs

    BPH cannot be cured, so treatment really focuses on reducing symptoms. It is based on how severe your symptoms are, how much they bother you and whether there are complications. This is all determined through a questionnaire from the American Urological Association.

    For mild symptoms, you may need to make small changes to your lifestyle but you will not need medication or surgery.

    For more moderate to severe symptoms, your doctor may prescribe medication. You may also be offered surgery or less invasive therapies, such as transurethral microwave therapy or transurethral needle ablation.

  • Prevention

    While there is no way to truly prevent BPH, there are some ways to help reduce the impact it has on your quality of life.

    • Do not rush urinating.
    • Spread your fluid intake throughout the day and limit fluid intake at night.
    • If possible, avoid medicines that make your symptoms worse.

This website contains general information about medical conditions and treatments. The information is not advice, and should not be treated as such. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. Please see the medical disclaimer page for full details.