Information From Your Health Care Provider

PROSTATIC HYPERPLASIA, BENIGN

(BPH; Prostate Hypertrophy)

Basic information

description

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate gland. The prostate is about the size of a walnut and is located just below the urinary bladder in men. An enlarged prostate presses against the urethra (tube that carries urine outside) making it narrower. The bladder muscle becomes thicker and more sensitive, causing urinary tract symptoms. BPH occurs more often in men over age 50.

FREQUENT SIGNS & SYMPTOMS

Increased urinary urgency and frequency, especially at night.
Weak urinary stream.
Stopping and starting again while urinating.
Straining and dribbling during urination.
Feeling that the bladder cannot be emptied completely.
Leaking of urine and sometimes blood in the urine.

causes

Exact cause unknown. It is common for the prostate to enlarge as a man ages. Changes in male hormones may be a factor.

risk increases with

Aging.
Family history of prostate problems.

PREVENTIVE MEASURES

No specific prevention measures are known.

expected outcomes

Symptoms may improve, worsen, or stay the same. A variety of treatments are available that can help to relieve the symptoms.

possible complications

Urinary retention, urinary stones, or urinary-tract infections.
Reduced kidney function.

diagnosis & treatment

general measures

Your health care provider will do a digital rectal exam (DRE). During a DRE, a gloved, lubricated finger is inserted into the rectum to feel the prostate gland's size and check for lumps. Blood levels of prostate-specific antigen (PSA) will be checked. Other medical tests may include urine flow rate study, urinalysis, urine culture, x-ray of the urinary tract, and ultrasound.
A question and answer interview is done about your symptoms. This can help in making treatment decisions. After treatment, it provides a good idea of how much the symptoms have improved.
Treatment may include watchful waiting, nonsurgical treatment, surgery, or drug therapy. Emergency treatment may be needed if all urine output is blocked.
Watchful waiting is an option. This means monitoring the symptoms for a time before deciding on treatment. For home care—urinate when you get the urge, use bathrooms when you get the chance, avoid drinking large amounts of fluid at one time, and reduce stress.
Several types of nonsurgical procedures are available. They include balloon dilation, prostatic stents, microwave therapy, needle ablation using radiofrequency, electrovaporization, and laser therapy. Your health care provider will explain and discuss these options.
Surgery may be recommended if there are more severe symptoms, complications occur, or there is a health risk. Several surgical options are available. The choice usually depends upon the size of the enlarged prostate. Surgery removes part of the prostate. The rest is left intact.

medications

Finasteride or dutasteride may be prescribed. They cause the prostate to shrink.
Alpha-adrenergic blockers may be prescribed. They help relax the muscles in the prostate.
Antibiotics if you develop a urinary-tract infection.
Get medical advice before using herbal remedies or other dietary supplements for BPH.
Read labels on nonprescription drugs. Avoid those that state "not recommended if you have prostatic hypertrophy," such as antidiarrheals or antihistamines.

activity

No limits unless advised. Exercise daily for good health.

diet

To help reduce symptoms of BPH, eat a diet low in fat and red meat and high in protein and vegetables. Avoid excess fluid intake. Limit caffeine and alcohol.

notify our office if

You or a family member has symptoms of BPH.
During treatment, any sign of urinary-tract infection occurs. This includes frequent, difficult, or painful urination, fever and chills, aching around the genitals or rectum, or backache.
New, unexplained symptoms develop.