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What is benign prostatic hyperplasia?

Benign prostatic hyperplasia (BPH) is a condition that occurs when the prostate enlarges, potentially slowing or blocking the urine stream. The prostate is a gland that surrounds the urethra (the tube that carries urine from the bladder out through the penis) and often gets bigger in men as they get older. It has nothing to do with prostate cancer. In fact, the word “benign” means “not cancer.”

The symptoms of BPH usually begin after age 50. The most common symptoms of BPH include:

  • Needing to urinate often, especially at night
  • Having trouble starting to urinate (this means that you might have to wait or strain before urine will come out)
  • Having a weak urine stream
  • Leaking or dribbling urine
  • Feeling as though your bladder is not empty even after you urinate

These symptoms tend to appear over time and may gradually worsen over the years. In a small percentage of men, untreated BPH can cause urinary retention, meaning that the man is unable to empty the bladder.

Symptoms of BPH can also be caused by other conditions, including prostate or bladder cancer, kidney stones, and overactive bladder. Overactive bladder causes a strong, frequent, uncomfortable need to urinate immediately. That is why it is important to see a doctor to make the correct diagnosis.

To know if BPH or another problem is causing your symptoms, a doctor will ask you questions, perform an exam, and do blood and urine tests.

If you do have BPH, your doctor can offer you different treatment options. If your symptoms don’t bother you very much, you may not need any treatment. On the other hand, if your symptoms do bother you, you probably should get treated.

You may be able to improve your BPH symptoms by making lifestyle changes such as:

  • Reducing the amount of fluid you drink, especially just before bed
  • Limiting the amount of alcohol and caffeine you drink. These drinks can make you urinate more often.
  • Avoiding cold and allergy medicines that contain antihistamines or decongestants. These medicines can make the symptoms of BPH worse.
  • Doing something doctors call “double voiding.” That means that after you empty your bladder, you wait a moment, relax, and try to urinate again.

For men with bothersome symptoms, treatment with one or more medicines or surgery is available. Doctors often suggest trying medicines first to see if they help. There are two main types of medicines to treat BPH. One type relaxes the muscles that surround the urethra. The other type keeps the prostate from growing more or even helps the prostate shrink. In some cases, doctors suggest taking both types of medicine at the same time.

If medicines don’t do enough, surgery is also an option. Surgery to treat BPH works by removing some of the prostate, or by causing the prostate to shrink. There are several surgeries to choose from. These include:

Transurethral resection of the prostate (TURP)–is the most common surgical treatment for BPH. The surgeon inserts a device through the urethra to remove strips of the enlarged prostate.

  • Microwave thermotherapy–this procedure uses heat to destroy excess prostate tissue. It is performed as a day surgery, and most men are able to go home after the procedure.
  • Laser surgery–with laser surgery, a surgeon uses laser to destroy prostate tissue and shrink the prostate. Laser surgery is similar to a TURP but causes less bleeding.
  • Removal of the prostate–surgery to remove the prostate (prostatectomy) might be recommended for men who are healthy and have a very enlarged prostate.

All of our physicians have been trained in treating men with an enlarged prostate and can provide the most up to date and comprehensive medical and surgical treatments for BPH.