Man in his 50s

If you’re getting up several times a night to go to the bathroom, you might blame normal aging. If you’re a man, your restless nights may stem from a condition called benign prostatic hyperplasia.

What Is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia (BPH) is better known as an enlarged prostate gland. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it’s the most common prostate problem for men over age 50. BPH affects half of men age 51 to 60 — and up to 90 % of those over age 80.

The prostate gland is a walnut-sized organ in front of the rectum, below the bladder. It produces part of the seminal fluid, which carries the sperm. When it grows too big, it can restrict urine flow.

The exact cause of BPH is unknown, but hormonal changes likely play a role.

BPH is not a cancerous condition, nor does it progress to cancer. But it can be bothersome and lead to urinary tract infections. Other potential complications include kidney failure, bladder stones, and blocked urine flow.

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What Are the Signs of Benign Prostatic Hyperplasia?

Some men have BPH and never develop symptoms because their urine flow is not blocked. Others have one or more of the following:

  • Weak or slow urine flow.
  • Dribbling at end of urination.
  • Inability to empty the bladder completely.
  • Incontinence, or accidental loss of urine.
  • Pain during urination.
  • Urinating often, especially at night.
  • A strong, sudden urge to urinate.
  • Having to strain to begin urine stream.

Risk Factors for BPH

Any man can get BPH, but you’re more likely to develop it if you have any of these risk factors:

  • Being 40 or older.
  • Family history of BPH.
  • Heart disease.
  • Type 2 diabetes.
  • Obesity.
  • Sedentary lifestyle.

How Do Doctors Diagnose Benign Prostatic Hyperplasia?

Your doctor will ask about your medical history and perform a physical exam to rule out kidney or bladder abnormalities. A rectal exam will help your doctor determine the size of the prostate.

Other tests may include:

  • Blood tests.
  • Pre- and post-massage test.
  • Post-void residual urine test.
  • Ultrasound.
  • Urinalysis.
  • Uroflowmetry.

What Is the Treatment for BPH?

There’s no cure for BPH, but doctors can relieve your symptoms.

Watchful waiting

If your symptoms are mild, your doctor may recommend watchful waiting. That means getting annual checkups, rectal exams, and other tests. Your doctor also may suggest lifestyle changes such as:

  • Limiting caffeine and alcohol, especially in the evening.
  • Emptying your bladder completely when you pass urine.
  • Not waiting for long periods of time before using the restroom.
  • Eating a healthy diet and losing weight if you need to.
  • Staying active (being sedentary contributes to urinary problems).

Drug therapy

Your doctor may prescribe medicine to shrink or slow the growth of the prostate. Sometimes a combination of medicines works best.

  • Alpha blockers relax the prostate and bladder neck to improve urine flow.
  • 5-alpha reductase inhibitors block production of the male hormone dihydrotestosterone (DHT), which may cause prostate growth.
  • Phosphodiesterase-5 inhibitors are erectile dysfunction drugs that relax muscles in the lower urinary tract.

Surgery

Doctors at UPMC specialize in the following minimally invasive treatments for BPH:

  • Transurethral needle ablation (TUNA). Your doctor will insert a catheter into the urethra. The catheter sends small needles into the prostate tissue. The needles give off high frequency radio waves that heat and destroy the tissue.
  • Transurethral resection of the prostate (TURP). Doctors pass a narrow tool with a wire loop into the penis and through the urethra to the prostate gland. Electricity passes through the wire, heating it and cutting the obstructing prostate tissue.
  • Photoselective vaporization of the prostate
    (PVP)
    . Doctors use a laser to destroy excess prostate tissue.
  • Water vapor thermal therapy.
    Doctors use a small needle inserted into the prostate to inject steam, which
    will destroy the prostate tissue.
  • Prostatic
    urethral lift
    . Doctors insert a small
    implant into the prostate that compresses the tissue, allowing better urine
    flow.
Sources

National Institute of Diabetes and Digestive and Kidney Diseases, Prostate Enlargement (Benign Prostatic Hyperplasia) Link

National Cancer Institute, “Understanding Prostate Changes" Link

UPMC, “Benign Prostatic Hyperplasia (BPH) Link

About Urology

The UPMC Department of Urology treats all manners of conditions involving the urinary tract and male reproductive organs. We treat those disorders both in children and adults. We have a multifaceted team of physicians and researchers working together to provide the best care. We provide cutting-edge treatments, and we continue to lead research into even better methods for diagnosis and treatment. U.S. News & World Report ranks UPMC Presbyterian Shadyside as among the best hospitals in the country for urological care.