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Almost all men experience some degree of benign prostatic hyperplasia (BPH) at some point during their lives. Commonly referred to as “enlarged prostate,” BPH is not the same thing as prostate cancer, but some men also have underlying prostate cancer in addition to BPH. Having a urology evaluation is important to determine the cause of the symptoms and to rule out a serious medical problem.

What is an Enlarged Prostate?

Benign prostatic hyperplasia (BPH) is a noncancerous condition where the prostate gland increases in size. BPH is a very common concern and it affects the vast majority of men as the prostate grows with age. Typical signs of BPH are slowing of the urine stream and the need to get up frequently during the night to urinate.

The prostate gland is located beneath the bladder. The urethra, which carries urine from the bladder to be emptied through the end of the penis, runs through the prostate. If the prostate is enlarged, it can put pressure on the bladder and slow or block the flow of urine.

As men get older, their prostate grows larger. Around age 50, approximately half of men have experienced BPH. Among men in their mid-80s and older, about 90% have symptoms.

Experts do not believe having an enlarged prostate increases the risk of prostate cancer. Although, untreated BPH may lead to urinary problems that require treatment.

Symptoms of Enlarged Prostate

The symptoms of BPH can vary between individuals, and may become more severe as men get older.

  • Urgent or frequent need to urinate
  • Need to urinate during the night
  • Difficulty starting to urinate
  • Weak urine stream
  • Urine that stops and starts, or dribbles when urination ends
  • Difficulty emptying the bladder completely

If symptoms progress and become more severe, you may experience other complications from the backup of urine in your system. This could include developing a bladder infection or bladder stones.

Some symptoms may indicate a serious condition. Seek immediate medical attention of you experience any of these symptoms:

  • Inability to pass any urine
  • Pain, fever and/or chills while urinating
  • Blood in the urine

Causes and Risk Factors of BPH

Experts do not know the exact cause of BPH. Many health care providers believe enlarged prostate may be the result of hormonal changes. As men get older, the amount of testosterone that is produced begins to decrease.

Some evidence suggests that certain conditions may be risk factors for BPH:

  • Family history
  • Diabetes
  • Obesity

Diagnosis of Enlarged Prostate

Even though enlarged prostate is not a harmful medical condition on its own, it is important to have an accurate diagnosis to rule out other serious problems. If you are experiencing any symptoms, you should see your health care provider.

To determine whether or not you have BPH (or to rule out another condition), your physician may perform one or more tests. The specific tests will depend on the severity of your individual symptoms and your medical history, and may include:

Digital rectal exam

Your physician conducts a manual exam, by reaching the prostate through your rectum, to feel for unusual lumps or abnormalities.

Prostate-specific antigen (PSA) test

A blood test to measure the amount of PSA present in your system. High levels of PSA may indicate prostate cancer.

Urine test

A sample of urine is sent to a laboratory to look for infections or other abnormalities.

Post-void residual volume test (PVR)

Using ultrasound technology to view the bladder, this test measures the amount of urine that remains in your bladder after you urinate.

Transrectal ultrasound (TRUS)

Using ultrasound technology, your physician can view the prostate to look for abnormalities.

Urinary flow test (Uroflowmetry)

While you urinate into a specified device/machine, your physician can measure how quickly your urine flows. Slower urine flow may indicate a blockage.

Cystoscopy

Using a local anesthetic, your physician inserts a device into and through your urethra to examine the prostate and bladder.

Prostate biopsy

Using a local anesthetic and ultrasound technology, your health care provider uses a needle to remove tissue from the prostate. The tissue sample is examined in a laboratory.

Treatment for BPH

Watchful waiting

If your symptoms are mild, your urologist may recommend delaying treatment and continuing with regular examinations to monitor your symptoms. You may be advised to limit your fluid intake before bed to reduce the need to urinate during the night.

Medication

Medications are usually the starting point for treating an enlarged prostate. Your physician may recommend medications that reduce the size of your prostate by treating hormonal imbalances that may be causing symptoms. Another type of medication aims to relax the muscles surrounding the prostate so that it is easier to urinate.

Surgical procedures

If your symptoms are bothersome and medication has not been effective, your physician may recommend additional treatment to improve the flow of urine through the urethra. The specific procedure will depend on the severity of your individual symptoms and your medical history, and may include:

Transurethral resection of the prostate (TURP)

The prostate is accessed through the urethra, and tissue is removed to reduce the blockage.

Transurethral incision of the prostate (TUIP)

Small incisions are made to widen the urethra to improve the flow of urine.

Water vapor treatment

Thermal (heat) energy creates water vapor used to reduce the amount of prostate tissue.

Laser therapy

Laser energy is used to reduce the amount of prostate tissue.

Prostatic urethral lift (UroLift)

Implants are placed on both sides of the prostate to widen the urethra.

Prostatectomy

The prostate is removed with robotic surgery if the prostate is extremely large or cancer is present.

Scheduling an evaluation

Memorial Hermann-affiliated urologists are committed to using a multidisciplinary approach to provide exceptional urological care. Our highly skilled practitioners utilize leading-edge treatments for a full range of men’s health concerns.

To find out if BPH treatment is right for you, schedule an appointment with a urologist today.