Photo: Laura James

Is BPH normal?

BPH is considered a normal condition of aging. Although the exact cause is unknown, changes in male sex hormones that come with aging may be a factor. Any family history of prostate problems or any abnormalities with your testicles may raise your risk for BPH.

healthline.com - BPH: Causes, Symptoms, Diagnosis, Treatment, and Complications

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About the prostate The prostate is a small, muscular gland in the male reproductive system. Your prostate surrounds your urethra and makes most of the fluid in your semen. The muscular action of the prostate helps propel the fluid and semen through your penis during sexual climax. In many men, the prostate can become enlarged. Sometimes it leads to symptoms and, over time, other complications. However, there are treatments. What is BPH? Enlargement of the prostate is called benign prostatic hyperplasia (BPH). It occurs when the cells of the prostate gland begin to multiply. These additional cells cause your prostate gland to swell, which squeezes the urethra and limits the flow of urine. BPH isn’t the same as prostate cancer and doesn’t increase your risk for cancer. However, it can cause symptoms that can affect your quality of life. BPH is common in men over 50. BPH causes BPH is considered a normal condition of aging. Although the exact cause is unknown, changes in male sex hormones that come with aging may be a factor. Any family history of prostate problems or any abnormalities with your testicles may raise your risk for BPH. Men who’ve had their testicles removed at a young age don’t develop BPH. BPH symptoms The symptoms of BPH are often very mild at first, but they become more serious if they aren’t treated. Common symptoms include: incomplete bladder emptying nocturia, which is the need to urinate two or more times per night

dribbling at the end of your urinary stream

incontinence, or leakage of urine

straining when urinating

a weak urinary stream

a sudden urge to urinate

a slowed or delayed urinary stream

painful urination

blood in the urine Talk with your doctor if you have any of these symptoms. They’re treatable, and treating them often can help prevent complications. BPH diagnosis When checking you for BPH, your doctor will usually begin by doing a physical exam and asking you about your medical history. The physical exam includes a rectal examination that allows the doctor to estimate the size and shape of your prostate. Other tests can include: Urinalysis. Your urine is checked for blood and bacteria. Your urine is checked for blood and bacteria. Urodynamic test. Your bladder is filled with liquid via a catheter to measure your bladder’s pressure during urination. Your bladder is filled with liquid via a catheter to measure your bladder’s pressure during urination. Prostate-specific antigen (PSA) test. This blood test checks for cancer of the prostate. This blood test checks for cancer of the prostate. Post-void residual. This tests the amount of urine left in your bladder after urination. This tests the amount of urine left in your bladder after urination. Cystoscopy. This is the examination of your urethra and bladder with a tiny lighted scope that’s inserted into your urethra Your doctor may also ask about medications you’re taking that might be affecting your urinary system, such as: antidepressants

diuretics

antihistamines

sedatives Your doctor can make any necessary medication adjustments. Don’t attempt to adjust your medications or doses yourself. Let your doctor know if you’ve taken self-care measures for your symptoms for at least 2 months without noticing any improvement. BPH treatment Treatment of BPH can begin with self-care and lifestyle adjustments. If symptoms don’t subside, medication or surgery may be recommended. Your age and general health will also influence the prescribed treatment. Learn more about BPH treatment.

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BPH natural treatment Natural treatment can include specific actions or lifestyle changes that you can make to help relieve your symptoms of BPH. These include: urinating as soon as you feel the urge going to the bathroom to urinate, even when you don’t feel the urge avoiding over-the-counter decongestants or antihistamine medications, which can make it harder for the bladder to empty

avoiding alcohol and caffeine, especially in the hours after dinner

reducing your stress level, as nervousness can increase the frequency of urination

exercising regularly, as a lack of exercise can aggravate your symptoms

learning and practicing Kegel exercises to strengthen your pelvic muscles

keeping warm, since being cold can make symptoms worse Some people also include natural remedies in their treatment of BPH. However, there isn’t evidence that they’re effective. Learn more about BPH natural remedies. BPH drugs When lifestyle changes aren’t enough to relieve your symptoms, your doctor may recommend medication. There are several medications that can help to both treat the symptoms of BPH and BPH itself. These medications include: alpha-1 blockers

hormone reduction medications

antibiotics Learn more about BPH medications. Alpha-1 blockers Alpha-1 blockers are medications that relax the muscles of the bladder and prostate. Alpha-1 blockers relax the neck of the bladder and make it easier for urine to flow. Examples of alpha-1 blockers include: doxazosin

prazosin

alfuzosin

terazosin

tamsulosin Hormone reduction medications Medications that reduce the levels of hormones produced by the prostate gland, such as dutasteride and finasteride, are commonly prescribed. These two medications lower the levels of dihydrotestosterone (DHT), a more potent variation of testosterone that affects hair and prostate growth, among other functions. Sometimes, lowering the hormone levels will make the prostate get smaller and improve urine flow. However, in rare cases, these medications may also lead to side effects such as impotence and a decreased sex drive. Antibiotics Antibiotics may be used if your prostate becomes chronically inflamed from bacterial prostatitis related to BPH. Treating bacterial prostatitis with antibiotics may improve your symptoms of BPH by reducing the inflammation. However, antibiotics won’t help prostatitis or inflammation that is not caused by bacteria. Surgery for BPH There are different types of surgical procedures that can help treat BPH when medications aren’t effective. Some procedures are either noninvasive or minimally invasive and can often be done in your doctor’s office or clinic (outpatient procedures). Others are more invasive and need to be done in a hospital (inpatient procedures). Outpatient procedures Outpatient procedures involve inserting an instrument into your urethra and into the prostate gland. They include: Transurethral needle ablation (TUNA). Radio waves are used to scar and shrink prostate tissue. Radio waves are used to scar and shrink prostate tissue. Transurethral microwave therapy (TUMT). Microwave energy is used to eliminate prostate tissue. Microwave energy is used to eliminate prostate tissue. Transurethral water vapor therapy (Rezūm). Water vapor is used to destroy excess prostate tissue. Water vapor is used to destroy excess prostate tissue. Water-induced thermotherapy (WIT). Heated water is used to destroy excess prostate tissue. Heated water is used to destroy excess prostate tissue. High-intensity focused ultrasonography (HIFU). Sonic energy is used to eliminate excess prostate tissue.

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Sonic energy is used to eliminate excess prostate tissue. Urolift. The enlarged prostate is surgically lifted with the help of implants so that it doesn’t block the urethra. Urolift and Rezūm have both been shown to be nearly as effective as inpatient surgical treatments like TURP, with the added benefits of being less invasive, less costly, and more likely to preserve sexual functionality. Inpatient procedures Inpatient procedures might be recommended if you have any of the following symptoms: kidney failure

bladder stones

recurrent urinary tract infections

incontinence

a complete inability to empty the bladder

recurrent episodes of blood in the urine Inpatient procedures include: Transurethral resection of the prostate (TURP). This is the most commonly used surgical treatment for BPH and remains the gold standard surgical treatment. Your doctor inserts a small instrument through your urethra into the prostate. The prostate is then removed piece by piece. This is the most commonly used surgical treatment for BPH and remains the gold standard surgical treatment. Your doctor inserts a small instrument through your urethra into the prostate. The prostate is then removed piece by piece. Simple prostatectomy. Your doctor makes an incision in your abdomen or perineum, which is the area behind your scrotum. The inner part of your prostate is removed, leaving the outer part. After this procedure, you may have to stay in the hospital for up to 10 days. Your doctor makes an incision in your abdomen or perineum, which is the area behind your scrotum. The inner part of your prostate is removed, leaving the outer part. After this procedure, you may have to stay in the hospital for up to 10 days. Transurethral incision of the prostate (TUIP). This is similar to TURP, but your prostate isn’t removed. Instead, a small incision is made in your prostate that will enlarge your bladder outlet and urethra. The incision allows urine to flow more freely. You aren’t always required to stay in a hospital with this procedure. Complications of BPH The symptoms of BPH can be easy to ignore. However, early treatment can help you avoid potentially dangerous complications. Call your doctor if you’re noticing symptoms of BPH. People with a long-standing history of BPH may develop the following complications: urinary tract infections

urinary stones

kidney damage

bleeding in the urinary tract

a sudden inability to urinate Sometimes, urinary obstruction from BPH is so severe that no urine can leave the bladder at all. This is called bladder outlet obstruction. It can be dangerous because urine trapped in the bladder can cause urinary tract infections and damage your kidneys. BPH vs. prostate cancer BPH and prostate cancer don’t share symptoms. Prostate cancer is almost always asymptomatic and identified by either an elevated PSA or prostate nodule. It’s also a more serious condition than BPH. Your doctor can test to make sure that your symptoms aren’t related to prostate cancer. Learn more about the similarities and differences of BPH and prostate cancer.

healthline.com - BPH: Causes, Symptoms, Diagnosis, Treatment, and Complications

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