Benign Prostatic Hyperplasia (BPH)

The prostate is a small gland that makes semen. As you age, the prostate grows. If it becomes too big, it may cause problems with urination. This condition is called benign prostatic hyperplasia (BPH).

Symptoms of BPH

BPH is common in men over age 60. That’s because the prostate grows bigger during a man’s life. As it grows, it presses against the urethra. The urethra carries urine out of your body from your bladder through your penis. Your bladder may also weaken as you age. It may not empty completely after you urinate.

Men with BPH may have these symptoms:

  • The urge to frequently urinate, especially at night

  • Leaking or dribbling of urine

  • A weak stream of urine

  • Not able to urinate, or having trouble starting to urinate

How BPH Affects the Bladder

Pushing to urinate through a narrowed urethra can cause the bladder walls to thicken or stretch out of shape. A stretched bladder may have problems emptying all the way. If urine stays in the bladder longer than it should, you may develop an infection or bladder stones. Also, the kidneys can’t drain properly into a bladder that doesn’t empty completely. This can lead to kidney failure. Pressure from urine buildup can also cause leaking of urine (called overflow incontinence).

Diagnosing BPH

BPH can hurt your bladder and kidneys. It can also lead to bladder stones and urinary tract infections. If you think you may have BPH, talk with your healthcare provider. Early treatment can prevent problems.

Several tests can diagnose BPH. These include:

  • Digital rectal exam. During this procedure, your provider puts a gloved, greased (lubricated) finger into your rectum to check the size of your prostate.

  • Imaging tests. X-rays and other imaging tests can find problems in your kidneys or bladder.

  • Cystoscopy. This test uses a flexible tube with a camera (scope) to look inside your urinary tract.

  • Urine flow study. This test uses a special device to see how fast urine leaves your body.

Treating BPH

If you have mild symptoms, you may not need treatment. You may be able to control your BPH with lifestyle changes. Some men feel better if they limit or avoid alcohol and caffeinated drinks like coffee. Not drinking too many fluids at night can also help. Increasing your physical activity may ease symptoms, too.

Kegel exercises may also help. They strengthen the pelvic muscle to prevent urine from leaking. While urinating, contract your pelvic muscle to stop or slow down the flow of urine. Hold for 10 seconds. Repeat at least 5 times. Do the exercise 3 to 5 times each day.

Certain medicines can worsen BPH symptoms. These include medicines for congestion, allergies, and depression. Medicines that increase your urine flow (diuretics) can also worsen BPH symptoms. If you take any of these, talk with your provider. You may need to take another medicine or change how much you take.

BPH symptoms often get worse as the prostate grows. So at some point you may need treatment. Your provider may prescribe medicine to shrink the prostate or stop its growth. Other treatments can make the urethra wider to let urine to flow more easily. There are also some minimally invasive techniques to remove prostate tissue.

If your BPH is severe, your health care provider may recommend surgery. Surgery takes out enlarged parts of the prostate gland. Your health care provider can figure out the best option for you based on your age, overall health, and other factors.

BPH and Prostate Cancer

BPH and prostate cancer share some symptoms. That’s why it’s important to talk with your provider about your symptoms. Men with BPH aren’t more likely to develop this cancer. But they may have higher levels of the prostate-specific antigen (PSA). A higher PSA level may also be a sign of prostate cancer. Certain tests help distinguish BPH from prostate cancer. They include prostate ultrasound and biopsy.

Other Prostate Problems

  • Prostatitis is an infection or inflammation that causes the prostate to become painful and swollen. The swelling narrows the urethra and can block the bladder neck. Prostatitis can cause a burning sensation during urination. You may also feel pressure or pain in the genital area. In some cases, prostatitis can cause fever and chills, and can make you very sick.

  • Cancer occurs when abnormal cells form a tumor (a lump of cells that grow uncontrolled). Some tumors can be felt during a physical exam, others can’t. Prostate cancer often causes no symptoms at all, especially in its early stages. Prostate symptoms are more likely to be caused by a problem that is NOT cancer.