Benign Prostatic Hyperplasia (BPH)
• Frequent or urgent need to urinate; delayed, weak,
or interrupted urine stream;
• Pain upon urination.
to urinate several times a night.
• Blood in the urine.
When to call a doctor
• Call a doctor if you develop symptoms of
What is it?
Benign prostatic hyperplasia (BPH) is a nodular,
irregular enlargement of the prostate, the walnut-size gland
located just below the
bladder in men, which produces about 30 percent of the fluid
portion of semen. Because the prostate surrounds the urethra
(the passageway through which urine empties from the bladder),
enlargement of the prostate may eventually constrict the urethra
and thus interfere with urination.
An enlarged prostate may
also cause the muscular bladder wall to thicken, as stronger
contractions are necessary to push
urine through a narrowed urethra.
Increased thickness of the wall of the bladder can reduce its ability to store
urine and can result in frequent need for urination and sudden strong urges to
BPH is common, and its incidence increases with age: Evidence
of BPH is present in over 50 percent of men by age 60. There
is no evidence that BPH leads to prostate
cancer; however, symptoms of both disorders are similar, and it is possible to
have BPH and prostate cancer at the same time. BPH responds well to treatment.
• The precise cause of BPH
• Male sex hormones play
• There is as yet no way
to prevent BPH.
• Patient history and physical
examination, which includes a digital rectal examination (DRE).
In DRE the doctor inserts
a gloved finger into the rectum
on the prostate gland to check for enlargement.
• Tests to measure the rate
of urine flow.
• Urine tests and cultures.
of retained urine within the bladder.
How to treat it
• Treatment may be unnecessary
for mild symptoms. This is known as "watchful
• Excess alcohol or fluid
intake, especially at night, should be avoided.
• There is growing
evidence that saw palmetto, an herbal remedy, may
help to relive BPH symptoms in some men.
• Your doctor may prescribe
medication such as finasteride (Proscar) to shrink the prostate
or drugs that relax smooth muscle tone in
• Heat treatment (the application
of heat to prostate tissue) can be used to alleviate symptoms
of BPH. An advantage
of this approach
is that it
on an outpatient basis using minimally invasive microwave or radio-frequency
• Removal of excess tissue
from an enlarged prostate via transurethral resection of the
prostate (TURP) is the most common surgical treatment.
A thin, lighted
viewing tube is passed through the penis into the urethra. A minuscule
cutting tool at the end of the tube is used to excise prostate
tissue that is pressing
upon the urethra.
• Open prostatectomy—surgical removal of obstructing
prostate tissue via an abdominal incision—may be necessary
when the prostate is unusually large.
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