Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that becomes increasingly common with age. Because the prostate surrounds the urethra just below the bladder, prostate growth can narrow the passage through which urine flows and contribute to urinary symptoms. BPH is not prostate cancer, but urinary symptoms can have different causes, making an accurate evaluation important.
How Does BPH Affect Urination?
An enlarged prostate can place pressure on the urethra and make the bladder work harder to empty. Over time, some men may have increasing difficulty emptying the bladder or develop urinary retention. Prostate size alone, however, does not determine how severe symptoms will be, which is why evaluation should consider the individual patient’s symptoms and urinary function.
What Are the Symptoms of BPH?
BPH can cause lower urinary tract symptoms (LUTS) involving urine flow, bladder emptying, frequency and urgency. Symptoms vary from person to person and may include:
- Frequent urination
- A sudden or urgent need to urinate
- Waking frequently at night to urinate (nocturia)
- Difficulty starting urination
- A weak or interrupted urine stream
- Stopping and starting while urinating
- Straining to urinate
- Dribbling after urination
- Feeling that the bladder has not completely emptied
When Should You See a Urologist?
Urinary symptoms are common, but they should not automatically be assumed to be caused by BPH. Infection, bladder conditions, medications, prostate inflammation and other urinary tract problems can produce similar symptoms. Evaluation can identify the cause and determine whether symptoms can be monitored or would benefit from treatment.
An inability to urinate requires prompt medical attention. Blood in the urine, fever or chills, painful urination, or significant lower abdominal or urinary pain also warrant medical evaluation.
What Causes BPH?
The exact cause of BPH is not fully understood. Aging and changes within the prostate, including hormonal and tissue changes, may contribute to prostate growth. BPH becomes increasingly common with age, and family history may also increase the likelihood of developing the condition.
Does BPH Increase the Risk of Prostate Cancer?
BPH is a benign condition and does not mean that a person has prostate cancer. However, BPH and prostate cancer can cause some similar urinary symptoms and may occur in the same patient. Evaluation of persistent or changing urinary symptoms helps determine what is causing them and whether additional testing is appropriate.
How Is BPH Diagnosed?
Evaluation begins with understanding your symptoms, how long they have been present and how much they affect daily activities, sleep and quality of life. Your urologist may also review medications, medical and family history, fluid and caffeine intake, and other factors that can affect urination before recommending testing.
Testing for BPH and Urinary Symptoms
Not every patient requires the same tests. Depending on your symptoms, medical history and initial evaluation, testing may include:
- Physical examination, which may include a digital rectal examination (DRE)
- Urinalysis to look for infection, blood or other abnormalities
- Prostate-specific antigen (PSA) blood testing when appropriate
- Post-void residual (PVR) measurement to determine how much urine remains in the bladder after urination
- Uroflowmetry to measure the rate and pattern of urine flow
- Ultrasound to evaluate the prostate, bladder or urinary tract
- Cystoscopy to examine the urethra and bladder when additional evaluation is needed
- Urodynamic testing in selected patients to evaluate bladder function and urinary pressure
The goal is not simply to confirm that the prostate is enlarged. A personalized evaluation helps determine whether the prostate is responsible for the symptoms, how much urinary function is affected and which treatment options may be most appropriate.
Can BPH Be Prevented?
There is no proven way to prevent BPH. Maintaining a healthy weight, staying physically active and following a balanced diet support overall health, but they should not be considered treatments that prevent prostate enlargement.
Managing Mild BPH Symptoms
If symptoms are mild and are not significantly affecting quality of life, treatment may not be necessary right away. Regular follow-up can monitor symptoms, while changes such as reducing fluids before bedtime, limiting caffeine and alcohol, and reviewing medications that may affect urination may help improve urinary symptoms.
If you have questions regarding treatments for Benign Prostatic Hyperplasia (BPH), please call today. Click here to request an appointment.
