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What is BPH?

Nov 1, 2021

As men get older, your body changes in ways you can’t always control.  In most men, one of those changes is that the prostate gets bigger. While it is a natural aging change but in some it leads to a condition called BPH, or benign prostatic hyperplasia. Your prostate surrounds part of your urethra, the tube which carries urine and semen out of your penis. When you have BPH, your prostate is larger than usual, which squeezes the urethra. This can cause your urine stream to be weak, waking you up a lot at night to go to the bathroom along. 

Many fear that BPH to be cancer. However BPH isn’t prostate cancer and doesn’t make you more likely to get it. BPH is quite common  especially in older men, and there are a lot of treatments options available which include lifestyle changes to medical & surgical treatment. Your physician can help you choose the best care based on your age, health, and how the condition affects you.

How does BPH occur?

Cause of BPH is not confirmed yet but hormonal changes with advancing age in men is thought to bring about this condition. Early during your teenage, your prostate actually doubles in size. Later in life, around age 25, it starts to grow again & continues to grow in some men for the rest of their lives. In some, it causes BPH.

Symptoms

As the prostate gets larger, it starts to pinch the urethra. This causes symptoms that affect your urine flow, such as:

  • Trickling when you finish
  • Difficulty in urination
  • A weak stream in which urine stops and starts again.

This  means your bladder has to work harder to push urine out. 

Over time, the bladder muscles get weak, which makes it harder for it to empty. This can lead to:

  • Feeling like you still have to use the urinal just  after you came out
  • Need to go more often – eight or more times a day
  • Incontinence (when you don’t have control over when you urination)
  • Sudden need to pee
  • Night walk to the urinal to pee
  • Urinary tract infections, bleeding, bladder damage, and bladder stones

BPH rarely leads to other conditions such as  kidney damage or, worst-case, cause a problem wherein you cannot pass urine at all. A larger prostate doesn’t mean you’ll have more or worse symptoms. It’s different for each person. In fact, some men with very large prostates have few, if any, issues.

Diagnosis and Tests

Your doctor will first talk to you about your personal and family medical history. This will include questions about your urinating habit. Next, your doctor will do a physical exam. This may include a digital rectal exam to check the size and shape of your prostate.

Basic tests: Your doctor may start with one or more of these:

  • Blood tests to check for kidney problems
  • Urine tests to look for infection or other problems that could be causing your symptoms
  • PSA (prostate-specific antigen) blood test. High PSA levels may be a sign of a larger-than-usual prostate. A doctor can also order it as screening for prostate cancer.

Advanced tests: Based on the results of those tests, your doctor may order additional tests to rule out other problems or to see more clearly what’s happening. These might include:

  • Different types of ultrasound to measure your prostate and see if it looks healthy.
  • Biopsy to rule out cancer.
  • Urine flow test 
  • Urodynamics testing to evaluate your bladder function.
  • Cystourethroscopy is a procedure using a  camera to examine the inside of the prostate, urethra and bladder. 

Treatment:

Lifestyle changes: 

  • Do exercises to strengthen your pelvic floor muscles
  • Lower the amount of fluids you drink, especially before you go out or go to bed
  • Drink less caffeine and alcohol

Medicine: For mild to moderate BPH, your doctor might suggest medicine. Some medications work by relaxing the muscles in your prostate and bladder. Others help shrink your prostate.

In some cases, your doctor may also suggest a traditional, open surgery or a robotic procedure to remove your prostate.

Any Complications?

BPH doesn’t lead to prostate cancer or make you more likely to get it.