What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy or benign prostatic obstruction, occurs when a man’s prostate gland is enlarged. The prostate gland is a walnut-shaped gland that is part of a male’s reproductive system. It responsible for producing fluid that is essential for a man’s fertility. It has two main growth periods.
The first period occurs during puberty while the second phase starts around the age of 25. Benign prostatic hyperplasia usually occurs during the second growth phase. The prostate gland surrounds the urethra, a tube that helps bring urine from the bladder out of the body.
When the prostate gland enlarges, the urethra can be narrowed and squeezed, causing the bladder wall to become thicker. Overtime the bladder wall may weaken and lose the ability to fully empty the urine from the bladder. This can lead to urinary problems such as urinary incontinence, which is a condition that makes you lose bladder control.
How common is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia is common condition that affects only men. Most often affecting men older than age 50. The occurrence of benign prostate hyperplasia increases as men age. Reports have shown that 50 percent of men will have benign prostate hyperplasia between the age of 51 and 60 while affecting up to 90 percent of men who are older than 80 years.
What are the symptoms of benign prostatic hyperplasia (BPH)?
The common symptoms of benign prostatic hyperplasia are:
- Having difficulty in getting a urine stream started and completely stopped (dribbling).
- Having feeling like you need to urinate, especially at night.
- A weak urine stream.
- Feeling that your bladder is not completely empty after you urinate.
- Having problems emptying the bladder such as an urge to urinate again soon after urinating or have pain during urination.
- Trouble in bladder storage like waking at night to urinate; frequent urination, a sudden, uncontrollable urge to urinate.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- You are completely unable to urinate.
- Have pain when you have urination.
- Have a fever over 38°C, chills, or body aches.
- The lower back is painful, just below your ribcage that is not related to an injury or physical effort.
- Have blood or pus in your urine or semen.
- A burning sensation while urinating.
- Feel painful when ejaculating.
- Problems controlling your urination during the day or at night.
- If urination problems have developed over a few weeks or a few months and frequently occur.
What causes benign prostatic hyperplasia (BPH)?
When men go through the process of getting older, they can face with benign prostatic hyperplasia. Although the cause for benign prostatic hyperplasia is still unknown clearly, that the changes in hormone balance and cell-growth factors causes the disease is believed.
Besides, men can have the illness due to genetics, which is especially true for severe condition requiring surgery in men younger than 60.
What increases my risk for benign prostatic hyperplasia (BPH)?
There are many risk factors for benign prostatic hyperplasia (BPH), such as:
- Age. It is reported that men younger than 40 rarely have symptoms caused by prostate gland enlargement, while about one-third of men experience moderate to severe symptoms by age 60, and about 50 percent do so by age 80.
- Family history. If one of your blood relatives is living with the disease, you are more at risk of getting it.
- Ethnic background. White and black men have higher risk of prostate enlargement. Black men might experience symptoms at a younger age than white men.
- Benign prostatic hyperplasia (BPH). Your risk can increase when you have diabetes type 2, heart disease, circulatory disease or use of beta blockers (drugs used to treat high blood pressure and fast heart rate).
- Erectile dysfunction. Also known as impotence, this is the inability to hold an erection. This can increase your risk for benign prostatic hyperplasia.
- Lifestyle. Obesity or inactivity increases the risk of benign prostatic hyperplasia. It is important to be physically active.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is benign prostatic hyperplasia (BPH) diagnosed?
Your doctor will diagnose benign prostatic hyperplasia by reviewing your symptoms, past health and a physical exam. Other tests may include the following:
- Digital rectal exam. This involves the doctor to physically test the prostate size by inserting a finger into the rectum.
- Urine test. Your doctor will analyze your urine to test for possible infection.
- Blood test. The blood test can reveal any problems with the kidney.
- Prostate-specific antigen (PSA) blood test. PSA is a substance that is produced by the prostate. When levels of PSA are high in the blood, this is a clear indication that the prostate enlarged.
- Neurological exam. This test can test the function of the brain and nervous system to rule out any other causes for urinary problems.
- Cystoscopy. This involves a tiny and flexible instrument called cystoscope to be inserted through the urethra, allowing the doctor to view inside the urethra and bladder.
- Biopsy. Your doctor may test a sample of the prostate to detect for any cancerous cells that could be prostate cancer.
- Urodynamic tests. These are series of tests to see how well the urethra and bladder store and release urine.
- Transrectal ultrasound. This ultrasound uses a device called a transducer that bounces safe, painless sound waves off organs to create an image of their structure. This ultrasound can detect any abnormalities with the prostate.
If you have any questions about any diagnostic test, you should talk to your doctor. Your doctor can further explain the details as well as your results.
How is benign prostatic hyperplasia (BPH) treated?
Treatment options for benign prostatic hyperplasia may include lifestyle changes, medication therapy, procedures or surgery. Treatment will depend on the size of your prostate, your age, your overall health, and the amount of discomfort that you are experiencing.
Medications that are used may include the following:
- Alpha blockers. These drugs can relax the smooth muscle of the prostate and the bladder. Drugs may include terazosin (Hytrinâ), doxazosin (Carduraâ), tamsulosin (Flomaxâ), alfuzosin (Uroxatralâ) and silodosin (Rapafloâ).
- Phosphodiesterase-5 inhibitors. Although these drugs are mainly used to treat erectile dysfunction, it has been recently used to reduce the urinary tract symptoms. It works by relaxing the smooth muscle in the lower urinary tract. These drugs may include tadalafil (Cialiâ).
- 5-alpha reductase inhibitors. These drugs block the production of DHT that accumulates when the prostate enlarges. These drugs may include finasteride (Proscarâ) and dutasteride (Avodartâ).
- Combination medications. There are many combination drugs that are more effective in treating BPH when compared to a single drug treatment. These drug combinations may include finasteride with doxazosin, dutasteride with tamsulosin and alpha-blockers with antimuscurinic (drugs to treat urinary incontinence).
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage benign prostatic hyperplasia (BPH)?
The following lifestyles and home remedies might help you cope with benign prostatic hyperplasia (BPH):
- Practice “double voiding.” You can do this by urinating as much as possible, relaxing for a few moments, and then urinating again.
- Urinate while sitting down instead of standing.
- Do not limit your fluid intake to avoid urinating. You could become dehydrated, which can cause other problems. It is good for you to drink fluids throughout the day.
- If you have to wake up at night many times due to urinating, you can prevent this by restricting your fluid intake in the evening and emptying your bladder before bedtime.
- Avoid caffeine and alcohol. Using these substances can make you urinate more often.
- Avoid medicines that can make urination difficult like nonprescription antihistamines, decongestants and allergy pills. Check with your doctor or pharmacist about all of the medicines you take.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: August 17, 2016 | Last Modified: April 17, 2017
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Benign prostatic hyperplasia (BPH). http://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/basics/risk-factors/con-20030812. Accessed Jul 15 2016.
Prostate enlargement: Benign prostatic hyperplasia. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperplasia-bph/Pages/facts.aspx. Accessed Jul 15 2016