Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia or BPH, is one of most common disease affecting the prostate. This condition affects the majority of men at some time during their lives. The prostate is sensitive to the male hormone testosterone. As men age, the prostate tends to enlarge, secondary to stimulation by testosterone.

This can eventually cause voiding difficulties. Even men in their twenties start to develop microscopic evidence of BPH. Men older than 50 are most commonly afflicted by these symptoms. As the prostate enlarges and encroaches on the urethra, a multitude of symptoms may develop. Obstructive symptoms such as hesitancy, double-voiding, weak stream, dribbling and a sensation of incomplete emptying may occur.

Irritative symptoms may also occur which include frequency, urgency and getting up at night to urinate. A thorough history and physical exam are important in diagnosing BPH. A prostate specific antigen (PSA), and possibly a urine flow and assessment of residual urine with a bladder ultrasound, may be necessary to assess the severity of the symptoms.

BPH Treatments and Symptoms

Treatments and symptoms for BPH may include the following:

  • Symptoms that are mild or that do not bother you (AUA score of 0 to 7) may be best treated by watchful waiting. This means you may make small changes to your lifestyle to control your symptoms. You do not take medicines or have surgery. You have regular checkups to be sure your symptoms are not getting worse.
  • The treatment of moderate to severe symptoms (AUA score of 8 or more) depends on how much you are bothered by them. If the symptoms are not greatly affecting your quality of life, you may choose watchful waiting or treatment with medicine. If the symptoms are bothersome or you want more aggressive treatment, you may be offered surgery or less invasive therapies, such as transurethral microwave therapy (TUMT) or transurethral needle ablation (TUNA).
  • Complications of BPH, such as ongoing inability to urinate, urinary tract infections, bladder stones, kidney damage, or ongoing blood in your urine, should be treated with surgery. You may also want surgery if your symptoms have not been helped with other treatments.