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Benign Prostatic Hyperplasia (BPH)

As men become older, they can experience prostate enlargement or benign prostatic hyperplasia. A common condition in men above 50, benign prostatic hyperplasia often causes bothersome urinary symptoms. An enlarged prostate may also cause urinary tract, kidney, or bladder problems. However, treatment is possible.

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia (BPH), also known as prostate enlargement, is a non-cancerous increase in the size of the prostate gland – a small organ below the bladder surrounding the urethra that carries urine from the bladder.

This usually occurs when the cells of the prostate gland start to multiply rapidly. Due to increased cells, your prostate gland becomes swollen and squeezes the urethra. As a result, you experience limited urine flow and other uncomfortable urinary symptoms.

However, BPH is not the same as prostate cancer. But if not treated timely, BPH can lead to highly uncomfortable symptoms and complications.


Most symptoms of BPH are caused because of a compressed urethra. But they can vary from person to person and usually become worse with time.

Common symptoms of BPH include:

  • A weak urinary stream
  • A sudden urge to urinate
  • Dribbling at the end of urination
  • Leakage of urine
  • Painful urination
  • Difficulty in starting urination
  • Nocturia – an urge to urinate twice or more each night
  • Delayed urinary stream
  • Need to strain while urinating

Less common symptoms of BPH include:

  • Blood in the urine
  • Urinary tract infection
  • Inability to urinate

In some cases, the symptoms subside or even improve over time. But If you experience severe or prolonged symptoms, seek medical attention to prevent further complications with the urinary tract. You should also visit your doctor to rule out other problems since some BPH symptoms overlap with the symptoms of other medical conditions.

What causes it?

The exact cause of BPH is yet to be known. However, most experts believe hormonal changes to be the reason for prostate enlargement in men. Abnormalities in your testicles or a family history of prostate issues usually increases the risk of developing BPH.

Besides, most men experience sustained prostate enlargement throughout life. As a result, most of them show urinary symptoms or a weak urinary flow as they become older. However, men who had a testicle removal surgery at a young age do not develop BPH.


At first, your doctor will ask you about your family and personal medical history, about your symptoms and how they affect your daily life. And then, your doctor will perform a physical examination including a rectal examination for two reasons:

  • To make sure there are no hard areas in the prostate, often a sign of prostate cancer
  • To assess the size and shape of your prostate

Then, your doctor may start with any of these tests:

  • Urinalysis: To check your urine for blood and bacteria
  • Blood tests: To check for any kidney problems
  • Prostate-specific antigen (PSA) test: High PSA levels may suggest an abnormally large prostate. In such a case, your doctor can order a screening for prostate cancer.
  • Cystoscopy: In this test, a small lighted scope is inserted into your urethra to examine your urethra and bladder.
  • Prostatic biopsy: A small prostate tissue sample is examined for abnormalities. Primarily done to rule out cancer
  • Urodynamic test: To evaluate your bladder function
  • Cystourethroscopy: A procedure performed using a camera to analyze the inside of the prostate, bladder, and urethra
  • Post-void residual: This test assesses the amount of urine left in your bladder after urination.

Based on the test results, your doctor can confirm the BPH diagnosis. And at the same time, these tests will help your doctor to rule out other conditions and treat complications accordingly.

How is benign prostatic hyperplasia treated?

For some men, BPH symptoms stop without treatment. Nonetheless, varied treatment options are available for BPH including medication, surgery, and invasive therapies. Your doctor will choose a treatment plan based on factors like:

  • your age
  • overall health
  • size of your prostate
  • symptoms

Medication is most commonly used to treat mild to moderate BPH symptoms. A lot of medicines can treat both BPH and BPH symptoms, to make the urine flow easier. Medicines used to treat BPH include antibiotics, hormone reduction medications, and alpha-1 blockers.

However, your doctor may recommend minimally invasive surgery or therapy if:

  • You have moderate to severe BPH symptoms
  • You want a definitive treatment
  • Medication has not eased BPH symptoms

You can also receive minimally invasive therapy or surgery if you have bladder stones, urinary tract obstruction, kidney problems, or blood in your urine. However, prostatic procedures usually involve health risks. Make sure to understand the risks and complications with your doctor before finalizing.


BPH symptoms can disrupt the quality of your life. However, with regular prostate checkups and specific lifestyle changes, you can make a big difference. In any case, men should not ignore BPH symptoms, whether severe or not. Early detection and treatment can significantly decrease the chances of complications and other health risks.

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