Benign Prostatic Hyperplasia
How common is benign prostatic
hyperplasia?
Benign prostatic hyperplasia is
common.
By age 60, about 50% of people with
a prostate will have some signs of BPH. By age 85, about 90% will have signs of
the condition.
About half of all people with BPH
will develop symptoms that require treatment.
What are the warning signs of benign
prostatic hyperplasia?
Your prostate surrounds your
urethra. When BPH causes your prostate to grow, it can cause blockage in your
urethra. As a result, early symptoms of BPH include:
Slowness or dribbling when you pee.
Difficulty starting to pee.
Uncontrollable leaking
(incontinence).
Sudden need to pee (urgency).
Need to get up at night to pee.
Inability to completely empty your
bladder.
Pain after ejaculating or while
peeing.
Your pee changes color.
Your pee smells.
What happens if you leave an
enlarged prostate untreated?
Without treatment, BPH can cause
further blockage in your urethra, and your symptoms may worsen. It may also
cause:
Urinary tract infection.
Bladder stones.
Blood in your pee.
Kidney damage due to pee backflow
from your bladder up to your kidney. The pee backflow increases pressure on
your kidney.
What causes benign prostatic
hyperplasia?
Healthcare providers and medical
researchers aren’t sure what causes BPH.
One theory is that, as you age, the
amount of testosterone in your body decreases (low testosterone). At the same
time, your estrogen levels remain the same. These hormone changes may cause
your prostate cells to grow. However, people who take supplemental testosterone
may develop or worsen BPH.
Older men and people AMAB also have
higher levels of dihydrotestosterone (DHT). DHT is a more potent form of
testosterone that increases the size of your prostate.
Is benign prostatic hyperplasia
contagious?
No, BPH isn’t contagious. You can’t
spread BPH to another person.
What type of doctor treats benign
prostatic hyperplasia?
If your healthcare provider suspects
you have BPH, they may refer you to a urologist. A urologist is a doctor who
specializes in treating conditions that affect your urinary system.
How is benign prostatic hyperplasia
diagnosed?
Your healthcare provider will review
your medical history, ask you questions and perform a physical examination.
Part of the physical exam involves a digital rectal exam.
During a digital rectal exam, your
healthcare provider will carefully insert their gloved digit (finger) into your
rectum. They’ll feel the edges and surface of your prostate, estimate the size
of your prostate and detect any hard areas that could be cancer.
Your healthcare provider may also
order:
A survey to evaluate the severity of
your symptoms.
A urine flow test to measure the
speed of your pee stream.
A study to detect how much pee
remains in your bladder after you’ve finished peeing.
A cystoscopy to look into your
bladder.
Can benign prostatic hyperplasia be
cured?
There isn’t a cure for BPH. However,
treatment options are available to help alleviate your symptoms.
How is benign prostatic hyperplasia
treated?
If you have mild symptoms, you may
not require any treatment. Your healthcare provider may recommend a “watchful
waiting” approach in which you schedule regular appointments to ensure your BPH
doesn’t get any worse.
Treatment options include:
Medications
The most commonly prescribed
medications relax the muscle in your prostate, which reduces tension on your
urethra. Examples include:
Tamsulosin (Flomax®).
Terazosin (Hytrin®).
Doxazosin (Cardura®).
Alfuzosin (Uroxatral®).
Silodosin (Rapaflo®).
Some medications decrease the
production of the hormone DHT, which can slow the growth of your prostate
gland. These medications are most beneficial to people with larger prostates.
Examples include:
Finasteride (Proscar®).
Dutasteride (Avodart®).
Your healthcare provider may
prescribe combined medications that help treat your symptoms as well as improve
your urine flow. One example is dutasteride and tamsulosin (Jalyn®).
After you start a medication, it may
take between one and eight weeks for your symptoms to improve.
Surgery
Several different types of surgery
can remove prostate tissue that blocks your urethra. These include:
Transurethral resection of the
prostate (TURP). Your urologist inserts a special instrument (resectoscope)
through your urethra that allows them to see and remove prostate tissue.
Transurethral incision of the
prostate (TUIP). Your urologist makes two small incisions in your prostate and
where your urethra and bladder join (bladder neck) to widen your urethra and
improve urine flow.
Transurethral electrovaporization.
Your urologist uses an electrode to heat your prostate tissue. This turns the
tissue cells in the enlarged areas of your prostate into steam.
GreenLight™ laser. Your urologist
uses a special laser to evaporate your enlarged prostate tissue.
After a surgical procedure, you
should be able to resume normal activities within a few days or a week.
Minimally invasive treatments
New BPH treatments are less invasive
and damaging to healthy tissue than surgery. In general, most of these
treatments are outpatient procedures, which means you can go home the same day
as the procedure. They’re also cheaper, have fewer side effects and allow for a
faster recovery. However, because these techniques are new, there isn’t much
information about their long-term effects or complications.
Examples of minimally invasive
treatments include:
Prostatic urethral lift. This
procedure separates your enlarged prostate lobes to make your urethra wider,
making it easier to pee. Your urologist inserts a special instrument (UroLift®)
into your urethra and up to your prostate. When the UroLift reaches the side
wall of your prostate, it ejects small implants that pull your prostate lobes
apart and open your urethra. Your urologist may place two to six implants,
depending on the size of your prostate.
Water vapor therapy. Your urologist
inserts an instrument into your urethra and moves it to your prostate. Your
urologist then ejects a needle into your prostate. The needle emits steam
vapor, which turns into water. The water’s thermal energy destroys your
prostate cells. Your body reabsorbs the dead cells, and your prostate shrinks.
Another name for this procedure is the Rezūm™ System.
The most common side effects of
these treatments include peeing more than normal and discomfort or irritation
while your prostate heals.
After a minimally invasive
procedure, you should be able to return to your normal activities in a few
days. You should see improvements in your symptoms within three to six weeks.
What is the best treatment for
benign prostatic hyperplasia?
TURP is the most effective treatment
for most cases of BPH.
However, in adults 65 and older,
medications and minimally invasive treatments are preferable. Older patients
may have more complications and a longer recovery time after surgery.
What can/can’t I eat/drink if I have
benign prostatic hyperplasia?
Fruits, vegetables and healthy fats
may benefit your prostate health. Consider following the Mediterranean diet or
incorporating more of the following in your meals:
Berries.
Broccoli.
Citrus.
Nuts.
Tomatoes.
Turmeric.
A poor diet may worsen your BPH. If
you have BPH, it’s a good idea to avoid processed foods, sugars and large amounts
of carbohydrates as well as:
Alcohol.
Caffeine.
Dairy.
Red meat.
Sodium (salt).
Can an enlarged prostate go back to
normal?
In some people with mild BPH, their
symptoms went away without treatment. If your symptoms don’t go away during a
watchful waiting approach, you and your healthcare provider should start
discussing treatment options.