Benign Prostatic Hyperplasia (BPH), also called benign prostatic enlargement (BPE), is a common condition where the prostate gland gets bigger. The prostate is a small gland below the bladder that surrounds the urethra, the tube that carries urine out of the body. BPH is not cancer, but it can cause problems with urination because the enlarged prostate squeezes the urethra. It’s very common in older men.
How Common? BPH affects about 50% of men in their 50s and up to 90% of men over 80.
Not Cancer: BPH is not prostate cancer and doesn’t increase the risk of cancer, but both can happen at the same time.
Cause: The exact cause is unknown, but it’s linked to aging and hormonal changes, especially a hormone called DHT that makes the prostate grow.
BPH can cause problems with urination, such as:
Frequent urination, especially at night.
Urgency: Feeling like you need to go right away.
Weak or slow urine stream.
Trouble starting or stopping urination.
Feeling like your bladder isn’t empty after you go.
Dribbling at the end of urination.
In severe cases, not being able to urinate at all (a medical emergency).
If BPH isn’t treated, it can lead to:
Urinary tract infections (UTIs).
Bladder stones.
Bladder damage from overworking or not emptying fully.
Kidney damage (rare, but possible if urine backs up into the kidneys).
Acute urinary retention (suddenly not being able to urinate, which needs immediate treatment).
To diagnose BPH, doctors may:
Ask about your symptoms and use a symptom score chart.
Do a physical exam (like a digital rectal exam to check the prostate).
Test your urine for infections or blood.
Do a PSA blood test to rule out prostate cancer.
Check how well you urinate with a urine flow test.
Use imaging like ultrasound or cystoscopy to look at the bladder and prostate.
Treatment depends on how bad your symptoms are. Options include:
Lifestyle Changes:
Drink less fluid before bed.
Avoid caffeine and alcohol.
Practice double voiding (urinating twice to empty the bladder fully).
Medications:
Alpha-blockers (like tamsulosin): Relax the prostate and bladder muscles.
5-alpha reductase inhibitors (like finasteride): Shrink the prostate over time.
Combination therapy: Using both types of medications together.
Minimally Invasive Procedures:
TUMT or TUNA: Use heat or radio waves to shrink the prostate.
UroLift: A procedure to hold the prostate away from the urethra.
Surgery:
TURP: The most common surgery to remove part of the prostate.
Laser surgery: Uses lasers to remove or shrink prostate tissue.
Open prostatectomy: For very large prostates (removes part of the prostate).
You can’t always prevent BPH, but a healthy lifestyle may help:
Eat a balanced diet with lots of fruits, vegetables, and whole grains.
Exercise regularly.
Maintain a healthy weight.
If you’re having trouble urinating or notice any symptoms, talk to a doctor. Early treatment can help prevent complications and improve your quality of life!
