Benign Prostatic Hyperplasia (BPH)
- Posted on: Aug 12 2020
What is Benign Prostatic Hyperplasia?
Benign Prostatic Hyperplasia is characterized by enlargement of the prostate which is commonly seen in elderly men. Since the bladder is enlarged, it starts pushing on your bladder which leads to urinary related symptoms. This condition is mainly seen in men between 51 and 60 years old. There is a higher risk of getting BPH if there is a family history, lack of exercise, or staying active and history of erectile dysfunction. The cause of prostate enlargement is not completely known but it is believed to be related to a change of testosterone levels and old age.
What are the symptoms of Benign Prostatic Hyperplasia?
Symptoms of BPH vary depending on the severity of the disease and they tend to gradually worsen over time. The most common signs and symptoms include:
- Increase frequency of urination at night
- Difficulty starting urination
- Urgent need to urinate
- Dribbling at the end of urination
- Weak urine stream
- Inability to completely empty the bladder due to the prostate pushing on the bladder
- Need to push/strain to urinate
What are the complications of Benign Prostatic Hyperplasia?
- Urinary tract infections: due to the inability to fully empty the bladder, the risk of getting a urinary tract infection increases.
- Bladder damage: since the bladder doesn’t empty completely the bladder does not contract back and damages the muscular wall of the bladder.
- Kidney damage: since untreated urinary tract infections can travel to the kidneys and cause scarring.
How is Benign Prostatic Hyperplasia diagnosed?
The diagnosis of BPH is based on family history, symptoms, and physical exam. Your medical provider will have a suspicion about BPH based on your symptoms for which they will do a digital rectal exam (DRE) where they would find a uniformly enlarged, firm, non-tender, and rubbery prostate. A blood test to check for your Prostate-specific antigen (PSA) will be ordered and an elevated value will indicate a prostate enlargement but it is not specific to this condition. A urine test is ordered to check for any urinary tract infection or other conditions that could cause similar symptoms.
How is Benign Prostatic Hyperplasia treated?
The treatment for BPH depends mainly on your age, the severity of symptoms, and the size of the prostate. If symptoms are mild to moderate, medications such as alpha-blockers (alfuzosin, doxazosin, tamsulosin, and silodosin) are prescribed to help relax the bladder muscles helping with urination. Also, 5-alpha reductase inhibitors such as finasteride and dutasteride are prescribed to help shrink your prostate by preventing hormonal changes. Minimally invasive surgeries are usually recommended if medications have not worked, symptoms are too severe or you prefer a definitive treatment. The most common procedure performed is the Transurethral resection of the prostate (TURP). During this procedure, all your prostate is removed except for the outer part. After this surgery, you most likely need a catheter placed for a while to help you drain your bladder. If you want to learn more about the treatment and procedure for BPH please click here.
For more information about benign prostatic hyperplasia follow the Urology foundation website.
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