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.
- Sedentary lifestyle.
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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.
What Is the Treatment for BPH?
There’s no cure for BPH, but doctors can relieve your symptoms.
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).
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.
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.
urethral lift. Doctors insert a small
implant into the prostate that compresses the tissue, allowing better urine
The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. U.S. News & World Report ranks UPMC Presbyterian Shadyside among the best hospitals in the country for urological care.