Benign prostatic hyperplasia, also known as BPH, is a condition that involves the gradual enlargement of the prostate.
The prostate is a walnut-sized male reproductive organ that produces the majority of seminal fluid. Because the prostate continues to grow throughout the course of a man’s life, it may enlarge to the point where it puts pressure on the urethra, bladder, and other surrounding structures.
This can lead to urinary symptoms, including difficulty urinating and feelings of not having completely evacuated the bladder.
As many as half of all men over the age of 50 meet the criteria for BPH. However, the majority of these men will not experience severe BPH symptoms. But for men who live to the age of 80, as many as half will experience significant urinary problems as a direct consequence of BPH. Because BPH is the result of ongoing natural rather than neoplastic growth, the kind of growth exhibited by tumors, the condition very rarely affects men under the age of 40 and is usually only seen in severe form in those over the age of 50.
Although nearly all men past the age of 50 experience some degree of prostatic hyperplasia, the size of the prostate does not directly correlate with the appearance or severity of symptoms. Whether or not someone experiences debilitating BPH symptoms is largely due to their unique physiology. And this is at least partially genetically mediated, with men who have a close blood relative with BPH far more likely to experience symptomatic forms of the condition.
Symptoms of BPH reflect interference with the urinary system and include:
- Frequent urges to urinate
- Mild urinary incontinence, often manifesting as not being able to make it to the bathroom in time
- Difficulty starting a urine stream
- A weak urine stream
- Dripping after urination has stopped
- And an inability to fully empty the bladder
In more severe cases, urinary tract infections may occur, along with blood in the urine or a complete inability to urinate.
BPH Diagnosis & Treatment
BPH is a relatively straightforward condition to diagnose. Your physicians will ask a series of questions regarding your symptoms and history. The doctor may then administer a digital rectal examination, which will oftentimes provide a conclusive diagnosis by itself. In some cases, your doctor may order a series of other tests, including urine samples, cystoscopy, blood tests, transrectal ultrasound or, where malignancy must be ruled out, a biopsy.
Once a diagnosis has been made, BPH can often be successfully managed with a combination of medications and minimally invasive procedures. For symptomatic BPH, your doctor may prescribe:
- Alpha blockers, which relax bladder muscles
- 5-alpha reductase inhibitors, which can shrink the prostate
- Cialis, which can treat an enlarged prostate as well as erectile dysfunction
For cases that are not completely resolved through medication alone, minimally invasive procedures such as the UroLift device, which physically relieves pressure on the urethra caused by an enlarged prostate, may be recommended. For refractory or severe cases, more invasive interventions, such as transurethral resection of the prostate, also known as TURP, may be the best option.