Benign Prostatic Hyperplasia

Symptoms of BPH

BPH is common in men older than age 60. That’s because the prostate grows bigger during a man’s life. As it grows, it presses against the urethra. The urethra is the tube that carries urine out of your body from your bladder through your penis. Your bladder may also get weak 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

Who is at risk of developing BPH?

You're more likely to develop BPH if you:

• Are age 40 or older. The chance of getting BPH increases as you get older.

• Have a family history of BPH.

• Drink alcohol excessively.

• Are a large person.

• Have type 2 diabetes.

• Don't get enough physical activity.

Diagnosing BPH

Because BPH can lead to keeping urine in your bladder, it can hurt your bladder and kidneys. It can also lead to bladder stones, blood in the urine, and urinary tract infections. If you think you may have BPH, talk with your health care provider. Early treatment can prevent problems.

Providers often decide to treat BPH based only on your risk factors and symptoms. Several tests may help confirm a diagnosis of 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.

• PSA blood test. This rules out prostate cancer as a cause of urinary symptoms if you have symptoms of BPH.

• Imaging tests. Transrectal ultrasound is a procedure where the technician inserts a transducer slightly larger than a pen into the rectum next to the prostate. The ultrasound image shows the size of the prostate and any abnormalities, such as tumors. This test can't reliably diagnose prostate cancer. X-rays and other imaging tests can find problems in your kidneys or bladder.

• Cystoscopy. This test uses a flexible tube with a camera (called a scope). The scope is passed up the urethra to look inside your bladder. It is done to rule out bladder cancer if there are red blood cells in your urine.

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

• Prostate ultrasound. This test uses sound waves to view the size and the inside of the prostate gland.

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 don't have alcohol and caffeinated drinks, such as coffee. Not drinking too many fluids at night can help. Increasing your physical activity may ease symptoms, too.

Kegel exercises may help. They make the pelvic muscle stronger to prevent urine from leaking. Contract your pelvic muscles as if you were 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.

Some medicines can make BPH symptoms worse. These include medicines for congestion, allergies, and depression. Medicines that increase your urine flow (diuretics or water pills) can also make BPH symptoms worse. 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. At some point, you may need treatment. Your provider may prescribe medicine to shrink the prostate or stop its growth or to relax muscles to improve urine flow. Other treatments can make the urethra wider to let urine flow more easily. There are also some minimally invasive methods to remove prostate tissue.

If your BPH is severe, your provider may advise surgery. Surgery takes out enlarged parts of the prostate gland. You and your provider can discuss the best choice for you based on your age, overall health, and other factors.

BPH and prostate cancer

BPH and prostate cancer share some symptoms and may happen at the same time. That’s why it’s important to talk with your provider about your symptoms. Men with BPH don't have cancer. But they may have higher levels of prostate-specific antigen (PSA). A higher PSA level may also be a sign of prostate cancer. Certain tests help tell BPH from prostate cancer. They include prostate ultrasound and biopsy.