Enlarged Prostate (BPH)
An enlarged prostate, or benign prostatic hyperplasia (BPH), is a common condition in men over 50 that occurs when the prostate gland grows larger than normal, potentially impacting urinary function.
What is the Prostate?
The prostate is a gland located just below the bladder in the male reproductive system. Its primary function is to produce fluid that is a component of semen.
Understanding BPH
Benign prostatic hyperplasia (BPH) refers to the enlargement of the prostate gland. "Benign" indicates that the condition is not cancer, and "hyperplasia" refers to excessive cell growth. BPH does not increase the risk of developing prostate cancer.
As the prostate grows throughout adult life, it may press against the bladder and pinch the urethra, which can slow or block urine flow. Over time, the bladder muscle may weaken from the effort of passing urine through a narrowed urethra, leading to incomplete bladder emptying.
Causes and Risk Factors
While the exact cause of continued prostate growth is unknown, researchers suspect that hormonal changes associated with aging may play a role. Factors that increase the likelihood of developing BPH include:
- Being age 40 or older.
- Having a family history of BPH.
- Living with conditions such as obesity, heart disease, blood circulation problems, type 2 diabetes, or erectile dysfunction.
- Lack of physical activity.
Symptoms
Symptoms of BPH often relate to urinary function:
- Frequent or urgent need to urinate.
- Waking up multiple times during the night to urinate.
- Trouble starting to urinate.
- A weak, slow, or intermittent urine stream.
- Dribbling after urination.
- Urinary incontinence.
- A feeling that the bladder is not completely empty.
- Pain during urination or after ejaculation.
- Urine with an unusual color or smell.
Seek medical attention immediately if you cannot urinate, have a fever and chills accompanied by painful or frequent urination, notice blood in your urine, or experience pain in the lower abdomen or urinary tract.
Potential Complications
BPH can lead to serious health issues, including:
- Acute urinary retention: A medical emergency where you suddenly cannot urinate at all.
- Urinary tract infections (UTIs).
- Bladder damage and bladder stones.
- Kidney damage.
Diagnosis
Providers diagnose BPH through a review of medical and family history, a physical exam, and potentially the following tests:
- Digital rectal exam (DRE): A provider checks the prostate for size, tenderness, or irregularities.
- Urine tests.
- PSA blood test (prostate-specific antigen).
- Urodynamic testing to assess urine retention and release.
- Cystoscopy to examine the urethra and bladder.
- Ultrasound of the prostate and urinary tract.
- Prostate biopsy to rule out cancer.
Treatment and Management
Treatment depends on symptom severity, overall health, age, and prostate size:
- Lifestyle changes: Reducing fluid intake before bedtime, limiting caffeine and alcohol, bladder training, and managing constipation.
- Medicines: Used to stop growth, shrink the prostate, or relax muscles to improve flow.
- Medical procedures: Minimally invasive procedures to widen the urethra or use heat to destroy part of the prostate.
- Surgery: Used for severe cases to remove part of the prostate or relieve pressure on the urethra.
Prevention
There is no known way to prevent BPH. Maintaining prostate health involves regular checkups, monitoring symptoms, and discussing risk factors with a healthcare provider.