What is benign prostatic hyperplasia (bph)?

Benign prostatic hyperplasia, or BPH, is an enlarged prostate gland. The prostate is a small gland that makes some of the fluid in semen. Prostate enlargement happens to almost all men as they age. It is usually not serious. BPH does not cause prostate cancer.

As the prostate gets bigger, it may partly block the flow of urine. You may have a hard time getting a urine stream started or completely stopped. You may have a weak urine stream, or you may have to urinate more often than you used to, especially at night. Most men find these problems easy to manage.

You do not need treatment unless your symptoms bother you a lot or you have other problems, such as bladder infections or stones. In these cases, medicines may help. Surgery is not needed unless the urine flow is blocked or the symptoms do not get better with medicine.

Every man's experience with BPH is different. Symptoms may get worse over time. For example, BPH can cause problems with urinating. In rare cases, severe obstruction of the urine flow can lead to complications. The complications can include complete or partial blockage of the urethra, or a urinary tract infection (UTI).

BPH causes urinary problems such as trouble starting and stopping the flow of urine, needing to urinate often, or feeling like your bladder isn't completely empty after you urinate. BPH does not cause prostate cancer and does not affect a man's ability to father children. It does not cause erection problems.

In most cases, you don't need treatment unless symptoms bother you or you have problems such as backed-up urine, bladder infections, or bladder stones. Medicines may help reduce symptoms. Home treatment, such as avoiding alcohol, may also help. Sometimes surgery is done to remove part of your prostate.

Your doctor can diagnose BPH by asking about your symptoms and past health and by doing a physical exam. Your doctor may ask you how often you have symptoms of BPH, how severe they are, and how much they affect your life.

Tests may include a urine test (urinalysis) and a digital rectal exam. The exam lets your doctor feel the size of your prostate. In some cases, a prostate-specific antigen (PSA) test is done to help rule out prostate cancer. (Prostate cancer and BPH are not related, but they can cause some of the same symptoms.)

Your doctor may do other tests to check things such as your kidney and bladder function.

Medicines are sometimes used to help relieve BPH symptoms. If you stop using medicine, symptoms usually come back.

Medicines include:

• Alpha-blockers. They relieve symptoms within a few weeks. But they don't stop the process of prostate enlargement. They include tamsulosin (Flomax) and terazosin (Hytrin).
• 5-alpha reductase inhibitors. These may reduce the size of an enlarged prostate. They may take 6 months or more to show any effect on symptoms. They include dutasteride (Avodart) and finasteride (Proscar).
• Anticholinergic agents. They may help with urinary problems related to an overactive bladder, such as frequency, urgency, or incontinence. They include tolterodine (Detrol) and oxybutynin (Ditropan).
• Phosphodiesterase-5 (PDE-5) inhibitors. These may reduce BPH symptoms for men who also have erectile dysfunction. An example is tadalafil (Cialis).

Combining medicines, such as an alpha-blocker with a 5-alpha reductase inhibitor, may improve symptoms more than either medicine alone.

The side effects will vary based on the medicine.

• Urinate as much as you can, relax for a few moments, and then try to urinate again.
• Sit on the toilet to urinate.
• Avoid caffeine and alcohol. These drinks will increase how often you need to urinate.
• Many over-the-counter cold and allergy medicines can make the symptoms of BPH worse. Avoid antihistamines, decongestants, and allergy pills, if you can. Read the warnings on the package.
• If you take any prescription medicines such as muscle relaxants, pain medicines, or medicines for depression or anxiety, ask your doctor or pharmacist if they can cause urination problems.

Surgery is done to decrease urinary symptoms and improve urine flow. Most surgeries do this by removing prostate tissue that is pressing on the urethra.

You may need surgery for BPH if you:

• Can't urinate.
• Have a partial blockage in your urethra.
• Keep having blood in your urine.
• Have kidney damage.

Your options for surgery will depend on many things, like the size of your prostate, your symptoms, concerns about complications, and your surgeon's experience.

Surgery often greatly improves the quality of life for those with severe symptoms. But surgery may cause erection problems or ejaculation problems. It may also make it hard to control urination (urinary incontinence).

Surgery choices

Types of surgery include:

• Transurethral resection of the prostate (TURP).
• Transurethral vaporization of the prostate (TUVP).
• Laser therapies.
• Thermal ablation therapies.
• Transurethral incision of the prostate (TUIP).
• Prostatic urethral lift (PUL), also called UroLift.
• Simple prostatectomy.

BPH is probably a normal part of aging in men, caused by changes in hormones and cell growth. Genetics may play a role, especially for severe BPH in men younger than 60. Men older than 50 have higher chances of developing BPH. Experts don't know why some men have more severe symptoms than others.

Benign prostatic hyperplasia (BPH) rarely has complications. When it does, they are often due to severe obstruction of the urine flow. These complications include:

• Complete blockage of the urethra (acute urinary retention, or AUR). This results in a complete inability to urinate. It can cause kidney damage, which may be reversed if the problem is diagnosed and treated before the damage becomes too severe.
• Long-term, partial blockage of urine flow from the bladder (chronic urinary retention, or CUR). This causes urine to remain in the bladder after urination (post-void residual urine).
• A urinary tract infection (UTI). But repeated urinary tract infections can also be caused by long-term inflammation or infection in the prostate (chronic prostatitis).

Other complications of BPH may include bladder stones or bladder infections and visible blood in the urine (gross hematuria).

Benign prostatic hyperplasia (BPH) is an enlarged prostate gland. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.