This is a health condition that usually appears with aging and it is called benign prostatic hyperplasia (BPH) or enlarged prostate gland. A small gland located below the bladder that helps produce semen is called the prostate. This gland becomes enlarged as a normal part of aging.
While some people do not notice any problems, others may experience some symptoms that bother them including blocked urine flow out of the bladder. However, it may cause bladder, urinary tract, or kidney problems as well.
There are different treatment options for people with BPH including medicines, surgery, and others. Treatment options are usually different among people with this condition because it depends on the prostate size, symptoms, and existing health problems.
Symptoms
Check below the most common BPH symptoms:
- Urinating problems
- Frequently urination, especially during nighttime
- Dribbling at the end of urination
- A urine stream that stops or starts or a weak urine stream
- People with benign prostatic hyperplasia often are not able to empty the bladder
- Sudden or frequent urge to urinate
Check below other BPH symptoms that occur less commonly:
- Inability to urinate
- Blood in the urine
- Urinary tract infections
Furthermore, some people may notice that symptoms worsen gradually while others notice that the symptoms remain the same or even improve.
In addition, the prostate gland size does not always determine the severity of the symptoms. For instance, some people may have severe symptoms with a slightly enlarged prostate while others have large prostate glands and experience mild symptoms.
Other Causes of Urinary Symptoms
There are multiple health problems that may cause symptoms similar to benign prostatic hyperplasia. For example:
- Inflammation of the prostate gland
- Urinary tract infections
- Narrowing of the urethra (a tube that carries the urine out of the body)
- Bladder tissue scarring
- Kidney or bladder stones
- Problems with nerves that control the bladder
- Cancer of the prostate gland or bladder
Moreover, the following medicines may also cause urinary symptoms similar to the BPH. Examples include:
- Allergy and cold medications
- Pain relievers (also called opioids)
- Tricyclic antidepressants
It is advised to visit a doctor if you experience any urinary problems because there are multiple factors that may cause them.
Causes
The prostate gland is located below the bladder and the tube that carries the urine out of the body from the bladder is called the urethra. Therefore, this tube goes through the center of the prostate gland. When it becomes enlarged, it may block the urine flow.
Generally, the prostate gland grows the entire life. However, experts do not fully understand why this gland becomes bigger but they think an imbalance in the sex hormones that occur with aging could play a role.
Risk Factors
Anyone may develop BPH but the following factors make you more prone to get it. Examples include:
- Aging – More commonly an enlarged prostate causes symptoms after 40 years old. However, it may appear before age 40 but it is less common.
- Family history – If you have a family member with prostate problems, your risk of developing ones increases.
- Diabetes and heart disease – As per studies, people with diabetes or heart disease are at higher risk of developing BPH.
- Obesity – People with excessive weight also are at increased risk of developing an enlarged prostate gland.
- Lifestyle choices – Lack of physical activity, smoking, misuse of alcoholic drinks, and a poor diet also elevate your risk of developing an enlarged prostate.
What Are The Potential Complications of Benign Prostatic Hyperplasia?
People with BPH who do not get treatment may experience the following complications. Examples include:
- Urinary retention – Some people with BPH may develop this complication. However, doctors may recommend a catheter that helps drain the urine from the bladder or surgery to get relief.
- Urinary tract infections (UTIs) – The risk of UTIs increases in people who cannot urinate. In most cases, people need surgery to remove a part of the prostate gland.
- Bladder stones or damage – When a person cannot empty the bladder completely it may lead to bladder stones or damage. As a result, it may lead to bladder irritation, blood in the urine, and blocked urine flow.
- Kidney damage – If you are unable to urinate, the pressure in the bladder increases and may cause damage to the kidneys or allow bladder infections to spread to the kidneys.
While treatments for BPH reduce the risk of complications, urinary retention, and kidney damage may cause life-threatening health problems.
In addition, benign prostatic hyperplasia usually does not increase the risk of prostate cancer.
Diagnosis
Physicians begin the diagnosis of this condition by asking certain questions about your medical history and a physical examination. It usually includes the following procedures and tests. For example:
- Digital rectal examination – During this procedure, doctors will insert a finger into the rectum to check if the prostate gland is enlarged.
- Urine test – It is used to check for urinary tract infections and other abnormalities that cause similar symptoms to BPH.
- Blood test – It helps determine whether you have kidney problems.
Thereafter, physicians may perform additional tests to confirm the condition. Examples include:
- PSA (prostate-specific antigen) blood test – Physicians perform this test to measure levels of a protein (PSA) produced in the prostate. If the results show an increased level of PSA, it indicates BPH.
- Urinary flow test – During this test, you will pee into a container that is attached to a machinery that measures the urine flow and how much urine passes. It helps determine if the condition improves or worsens over time.
- Postvoid residual volume test – It helps measure whether a person can empty the bladder fully. It is usually done by using an imaging examination (ultrasound).
- 24-hour voiding diary – It involves noting how much and often you urinate.
Additional Tests
People with a more serious health condition may need the following tests too. These include:
- Transrectal ultrasound – This test involves a specific device that uses sound waves to make detailed pictures of the prostate gland.
- Prostate biopsy – During this procedure, your doctor will use a needle to take a small amount of prostate tissue and send it to the laboratory for testing. In such cases, doctors check for cancerous cells.
- Urodynamic and pressure flow studies – It involves a catheter that is threaded through the urethra into the bladder. Thereafter, either water or air is sent into the bladder to measure the pressure inside it. This test helps measure how bladder muscle works when you try to urinate.
- Cystoscopy – It involves a small flexible tool with a camera at the end that is inserted into the urethra. It helps your doctor see inside the bladder and urethra.
Treatment
Sometimes, the BPH symptoms may go away even without treatment. However, some people need treatment which usually includes medicines, surgery, and other procedures. The best treatment for you depends on several factors including severity of the symptoms, prostate size, your age, and others. Check below some treatments usually recommended by doctors:
Medications
The following medicines are usually recommended by doctors for people with mild benign prostatic hyperplasia. Examples include:
- Alpha-blockers – These medicines are effective for people with mild BPH and they work by relaxing the bladder muscle and prostate gland, which makes urination easier. Physicians usually prescribe Tamsulosin, Doxazosin, Alfuzosin, Silodosin, and Terazosin.
- 5-alpha reductase inhibitors – This group of medicines is used to shrink the prostate gland by blocking the hormones that provide its growth. Doctors often recommend Finasteride or Dutasteride.
- Combination therapy – Healthcare professionals usually prescribe multiple medicines if only one is not effective for you.
- Erectile dysfunction (ED) medications – While these medicines are used to treat erectile function problems in men, sometimes doctors may recommend Tadalafil to treat an enlarged prostate gland.
Surgery
Doctors often recommend surgery and other procedures for people with BPH in the following cases. Examples include:
- Medicines are not effective
- Kidney problems
- Experience urinary tract infections, blood in the urine, or bladder stones
- Unable to urinate
Check below some cases where surgery cannot be performed:
- Medical history of prostate radiation therapy or urinary tract surgery
- Untreated UTI
- Neurological disorders (including Parkinson’s disease or multiple sclerosis)
- Urethral stricture disease
In addition, check below some adverse reactions that may occur after surgery or procedures for an enlarged prostate gland:
- Bleeding
- Erectile function problems
- Urinary tract infections
- Leaking urine by accident
- Retrograde ejaculation (it occurs when semen flows back into the bladder)
Other Treatments
Check below the most common surgeries and other procedures usually involved in BPH treatment:
- TURP (transurethral resection of the prostate) – During this procedure, doctors use a small tool with a light (a scope) that is inserted into the urethra. Thereafter, surgeons will remove the outer part of the prostate gland. However, TURP helps relieve BPH symptoms quite fast.
- TUIP (transurethral incision of the prostate) – This procedure also is performed with a scope but it involves one or two small cuts in the prostate gland that help urine to pass through the urethra.
- TUMT (transurethral microwave thermotherapy) – This procedure is done to shrink the prostate gland and improve urine flow. It involves a catheter placed through the urethra into the prostate area. Thereafter, the microwave energy that comes from this catheter destroys the inner part of the prostate.
- WVTT (water vapor thermal therapy) – This involves a specific device that is placed in the urethra and turns water into steam. Therefore, the enlarged part of the prostate is removed.
- Robotic waterjet treatment – This treatment option involves imaging tests and robotic tools to guide a specific device into the urethra. After that, the device releases small but powerful jets of water that help get rid of extra tissue from the prostate gland.
- Open or robot-assisted prostatectomy – This is a surgery in which doctors make either one or more cuts in the lower stomach area to reach the prostate gland. In most cases, doctors recommend this surgery for people with large or very large prostate glands. After treatment, you may need to stay in a hospital for a short period.
- PAE (prostate artery embolization) – Sometimes, physicians recommend PAE in which the blood supply to certain areas of the prostate gland is blocked. As a result, it becomes smaller, which helps improve urinary symptoms.
Laser Therapy
This is a procedure that involves a powerful energy laser that destroys the extra tissues of an enlarged prostate gland. Physicians usually recommend laser therapy for people who should not have any other prostate surgeries or procedures because they administer anticoagulants (also called blood thinners). Check the laser therapy options below:
- Ablative procedures – These include photoselective vaporization of the prostate (PVP) and holmium laser ablation of the prostate. These procedures help improve urinary symptoms by destroying extra tissue of the prostate.
- Enucleation procedures – Generally, this procedure includes holmium laser enucleation of the prostate (HoLEP) and helps get rid of extra prostate tissue that blocks blood flow and prevents it from growing back.
Home Remedies
Check below some tips that may help control BPH symptoms. Examples include:
- Do not drink much water, especially 2 hours before bedtime
- Limit alcohol and caffeine beverages because bladder irritation and increased urination may occur.
- Avoid foods with lots of seasoning because they can cause bladder irritation.
- Regularly exercise
- Try to get and maintain a healthy weight. If you facing problems with losing weight, discuss it with your healthcare professional.
Frequently Asked Questions
What are the primary causes of benign prostatic hyperplasia?
While the exact cause of BPH is not fully understood, physicians think that hormonal imbalances that commonly occur in older people could play a role.
What are the main BPH symptoms?
These include:
- Erectile dysfunction (ED)
- Urinating problems
- Blood in the urine or semen
- Pain during urination or ejaculation
- Sudden and frequent urge to urinate
If any of the previous symptoms occur, immediately contact your healthcare professional.
What are the potential complications of BPH?
People with benign prostatic hyperplasia may also experience some complications, especially if they do not get treatment. For example:
- Urinary tract infections
- Hematuria
- Bladder or kidney stones
- Urinary retention
- Weak urine stream
- Bladder damage
- Kidney disease
- Nocturia
Ask your healthcare professional if you have additional questions.
