Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The prostate is usually a walnut-sized gland located at the neck of the bladder. It surrounds the urethra, a tube that carries urine from the bladder to the outside of the body. An enlarged prostate puts pressure on the urethra and can make it difficult for urine to pass. Eventually, the urethra may become completely closed off.

  • Causes

    The exact cause of BPH is unknown. It may be related to natural changes in hormone level that occur as men age.

    The enlargement is not due to cancer.

  • Definition

    Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The prostate is usually a walnut-sized gland located at the neck of the bladder. It surrounds the urethra, a tube that carries urine from the bladder to the outside of the body.

    An enlarged prostate puts pressure on the urethra and can make it difficult for urine to pass. Eventually, the urethra may become completely closed off.

    Enlarged Prostate
    BPH prostate
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    Your doctor will ask about your medical history and symptoms. If your doctor suspects BPH, a digital rectal exam may be done. A gloved finger is inserted into the rectum to assess the prostate.

    To assess problems with urine flow your doctor may recommend:

    • Urine flow study
    • Cystometrogram (a functional study of the way your bladder fills and empties)
    • Post-void residual volume test—measures whether you can empty your bladder completely

    Images of the prostate and urinary tract may be taken with:

    • Transrectal ultrasound
    • Cystoscopy
      —this test allows a doctor to look inside the urethra and bladder
    • X-ray
      of the urinary tract
      (if you have other symptoms as well)

  • Prevention

    Prostate enlargement occurs naturally with age. There are no prevention steps.

  • Risk Factors

    BPH is most likely to occur in men aged 50 years or older. Other factors that may increase your chance of having BPH include:

    • Metabolic syndrome—A condition marked by elevated blood pressure, cholesterol, blood glucose, and body weight. Excess weight centered around the midsection is of particular concern.
    • Obesity
    • Lipid disorders
    • Diet high in fats and red meat

  • Symptoms

    Enlarged prostate itself does not cause symptoms. Symptoms develop when the prostate gland puts enough pressure on the urethra to interfere with the flow of urine.

    Symptoms usually increase in severity over time and may include:

    • Difficulty starting to urinate
    • Weak urination stream
    • Dribbling at end of urination
    • Sensation of incomplete bladder emptying
    • Urge to urinate frequently, especially at night
    • Deep discomfort in lower abdomen
    • Urge incontinence
      —strong, sudden urge to urinate

  • Treatment

    Treatment is not needed for mild cases. Most men with BPH eventually request medical intervention to help with urinary symptoms.

    Treatments include: