Benign Prostatic Hyperplasia (BPH): Understanding an Enlarged Prostate

As men age, their prostate gland, a walnut-sized gland located below the bladder, can naturally enlarge. This non-cancerous enlargement is called Benign Prostatic Hyperplasia (BPH). While BPH isn’t life-threatening, it can cause bothersome urinary symptoms that disrupt daily activities and sleep.

What Happens During BPH?

The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. When the prostate enlarges due to BPH, it squeezes the urethra, making it harder to urinate. This can lead to a variety of symptoms, including:

• Frequent urination: A frequent urge to urinate, even at night (nocturia)
• Hesitation: Difficulty starting urination
• Straining: The need to push or strain to urinate
• Incomplete emptying: The feeling of not fully emptying the bladder
• Weak stream: A slow or weak urine flow
• Dribbling: Leaking urine after urination

Risk Factors for BPH

While the exact cause of BPH remains unknown, certain factors increase the risk:

• Age: The risk of BPH increases significantly with age. Most men over 50 experience some degree of prostate enlargement, though not everyone develops bothersome symptoms.
• Family history: Having a father or brother with BPH increases your risk.
• Lifestyle: Obesity and lack of exercise may contribute to BPH development.
• Hormonal changes: Decreasing testosterone levels and an increase in estrogen may play a role.

Diagnosing BPH

If you’re experiencing urinary symptoms suggestive of BPH, consult your doctor. Early diagnosis and treatment can help manage symptoms and prevent complications. Diagnosis may involve:

• Medical history: Discussing your symptoms and overall health.
• Physical exam: A digital rectal exam (DRE) to check the prostate size and consistency.
• Urinalysis: A test to rule out infection.
• Uroflowmetry: Measures the volume and force of your urine stream.
• Post-void residual (PVR) test: Measures the amount of urine remaining in the bladder after urination.
• Prostate-specific antigen (PSA) test: While not a definitive test for BPH, it helps rule out prostate cancer.

Treatment Options for BPH

Treatment for BPH depends on the severity of symptoms and your overall health. Options include:

• Lifestyle changes: Losing weight, exercising regularly, and reducing alcohol and caffeine intake can help manage symptoms in mild cases.
• Medications: Medications like alpha-blockers relax the muscles in the prostate and bladder neck, improving urine flow. Other medications may help shrink the prostate or reduce nighttime urination.
• Minimally invasive procedures: These procedures use various techniques to open up the blocked urethra. Options include microwave therapy, water vapor therapy, and prostate artery embolization.
• Surgery: Surgery is usually considered for severe cases where other treatments haven’t provided relief. Options include traditional open surgery or robotic-assisted surgery to remove part of the prostate gland.

Living Well with BPH

BPH is a manageable condition. By working with your doctor to diagnose and treat your BPH, you can improve your urinary symptoms and overall well-being. Here are some tips:

• Maintain a healthy lifestyle: Eat a balanced diet, exercise regularly, and manage stress.
• Manage fluid intake: Drink plenty of fluids throughout the day, but limit fluids before bedtime to reduce nighttime urination.
• Empty your bladder completely: Don’t rush urination and try to empty your bladder completely each time.
• Schedule regular checkups: Monitor your BPH and discuss any changes with your doctor.

Don’t hesitate to talk to your doctor if you experience any urinary symptoms suggestive of BPH. Early diagnosis and treatment can help you manage the condition and maintain a good quality of life.