Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, commonly affecting men as they age. While the condition is not life-threatening, it can significantly impact quality of life due to its effects on urinary function.
What is BPH?
The prostate is a small gland that sits just below the bladder and surrounds the urethra, the tube that carries urine from the bladder out of the body. As men age, the prostate often enlarges, which can lead to pressure on the urethra and interfere with normal urination.
Symptoms of BPH
The symptoms of BPH vary but commonly include:
- Frequent urination, especially at night (nocturia)
- Weak or interrupted urine stream
- Difficulty starting urination
- Inability to fully empty the bladder
- Dribbling at the end of urination
While these symptoms are common, they can also be caused by other conditions, so it’s important for men experiencing them to consult a healthcare provider for a thorough evaluation.
Risk Factors
BPH is primarily related to aging. It is estimated that over 50% of men in their 60s and 90% of men in their 70s and 80s have some form of prostate enlargement. Other risk factors include:
- Family history: Having a father or brother with BPH increases the likelihood of developing the condition.
- Obesity: Obese men are at a higher risk of developing BPH, and they may experience more severe symptoms.
- Lifestyle factors: Lack of physical activity, high-fat diet, and certain other health conditions (such as diabetes and high blood pressure) can contribute to the development of BPH.
Diagnosis
A urologist diagnoses BPH through a combination of:
- Medical history and symptom review: Understanding the patient’s symptoms and overall health.
- Physical exam: Including a digital rectal exam (DRE) to assess the size and shape of the prostate.
- Urine tests: To rule out infections or other issues that could mimic BPH.
- Blood tests: To measure prostate-specific antigen (PSA) levels and rule out prostate cancer.
- Ultrasound or bladder scan: To check for urine retention or other abnormalities.
Treatment Options
Treatment for BPH depends on the severity of the symptoms and the impact on quality of life. Options range from lifestyle changes to medications and surgery.
- Lifestyle Modifications: For mild cases, adjusting fluid intake, reducing caffeine and alcohol, and managing stress can help alleviate symptoms.
- Medications:
- Alpha-blockers: These medications relax the muscles of the prostate and bladder neck, easing urination.
- 5-alpha-reductase inhibitors: These drugs shrink the prostate over time by blocking the hormones that cause prostate growth.
- Combination therapy: Sometimes, a combination of alpha-blockers and 5-alpha-reductase inhibitors is used for more severe cases.
- Minimally Invasive Procedures:
- Transurethral resection of the prostate (TURP): A common surgical procedure where part of the prostate is removed to relieve pressure on the urethra.
- Laser therapy: Using lasers to remove or shrink excess prostate tissue.
- UroLift®: A device that lifts and holds the enlarged prostate tissue out of the way, opening up the urethra.
- Surgical Options: For more severe cases, especially when other treatments fail, a prostatectomy (removal of the prostate tissue) may be recommended.
When to See a Urologist
If you are experiencing symptoms such as frequent urination, difficulty urinating, or a weak urine stream, it’s important to consult a urologist. A timely diagnosis and treatment plan can help manage symptoms, improve quality of life, and rule out more serious conditions, such as prostate cancer.
