Benign Prostatic Hyperplasia “BPH”

Published: April 22, 2019
three men fishing with text benign prostatic hyperplasia (bph)

What is it?

Benign Prostatic Hyperplasia (BPH), is more commonly known as an enlarged prostate. The prostate is a walnut-sized gland that’s located below the bladder in men. Its primary function is to create the fluid for semen. Normally the prostate doubles in size during puberty, and then slowly grows after men reach age 25. BPH usually develops during the second stage of growth.1

What causes it?

A definitive cause isn’t clear at this point, but BPH is seen most commonly in older men and studies suggest that hormone changes in the body could play a role.1 In addition, the following are considered risk factors:2  

  • Age: BPH in men younger than 40 is rare but BPH is quite common as men age. About half of men aged 51 to 60 have BPH. By the time men reach age 85, 90% of them have some symptoms of BPH.1
  • Genetics: If you have a family history of prostate problems, you’re more likely to experience prostate complications as well.
  • Health: Patients who have diabetes, erectile dysfunction, or have used beta blockers to treat heart disease may be at an increased risk of BPH.1,2

Lifestyle choices: Obesity increases the likelihood of developing BPH. Inversely, a healthy diet and physical exercise can lower your risk.2

What are the symptoms?

Symptoms present differently in every patient, but they generally get worse over time if BPH is not treated.2

Patients can experience any or all of the following:

  • Difficulty or straining during urination
  • Urine incontinence (leakage)
  • Urgency (sudden need to go)
  • Frequent urination
  • Nocturia (frequent urination at night)
  • A weak urine stream
  • An inability to fully empty the bladder
  • The urge to urinate, even after emptying the bladder
  • The tendency to start and stop urinating
  • Hematuria (blood in urine)

In severe cases of BPH, a patient might not be able to urinate at all. This is an urgent medical issue that needs immediate treatment.1

How to diagnose?

The American Urological Association has developed a BPH Symptom Score Index.1

When you visit a urologist, your doctor will discuss your medical history and symptoms, and if applicable your score on the BPH Symptom Score Index. In addition, your physician may perform a variety of tests including:1,2

  • A blood test to get the full scope of your health
  • A urine test to rule out any other underlying urological conditions
  • A PSA test to look for prostate cancer
  • A digital rectal exam to physically check prostate size
  • Ultrasound imaging to examine the kidney and prostate
  • A cystoscopy to examine the urethra and bladder

What’s the treatment?

The treatment recommendations vary based on each individual’s health and symptoms. If BPH is mild, and symptoms aren’t interfering with a patient’s quality of life, a wait and watch approach with no immediate action may be best.1 There are also oral medications, lifestyle modifications, and minimally invasive surgical procedures that can help some cases of BPH. Most BPH is treated with oral medication.

In other cases, or when oral medications have failed, your urologist may recommend:

  • Urolift which lifts the prostate off of the urethra to provide relief.
  • Laser therapy to reduce overgrown prostate tissue.2
  • Transurethral resection of the prostate (TURP), involves a urological surgeon removing all but the outer section of the prostate to improve urine flow.2
  • Clinical trials are ongoing for this condition and therefore new treatments are being evaluated on a regular basis.

The final word:

If you’re dealing with unwanted urinary symptoms, Virginia Urology can help. We’ll get to the bottom of what’s causing your discomfort and will work with you one-on-one to develop a care plan that works best for your unique situation.



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