Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is a condition in which the prostate gland becomes enlarged. However, the actual size of the gland does not always predict symptom severity. Some men with enlarged prostate glands may experience symptoms while some men with even larger glands may have few symptoms. BPH is very common among older men, affecting about 60% of men over age 60 and 80% of men over age 80.
BPH Symptoms
The symptoms associated with BPH are collectively called lower urinary tract symptoms (LUTS). These are generally classified as either voiding (obstructive) symptoms or storage (irritative) symptoms.
Voiding symptoms may be caused by narrowing of the lower urinary tract (urethra). Voiding symptoms include:
- Weak or intermittent urinary stream
- Hesitation before urine flow starts or straining when urinating
- Sense that bladder has not emptied completely
- Dribbling at end of urination or leakage afterward
Storage symptoms include:
- Increased frequency of urination, especially at night
- Urgent need to urinate
- Bladder pain or irritation when urinating
More serious BPH symptoms may include:
- Blood in the urine
- Recurrent urinary tract infection
- Back-up of urine into the kidneys
- Acute urinary retention (inability to void)
Treatment
BPH is not a cancerous or precancerous condition. It rarely causes serious complications, and men usually have a choice whether to treat it immediately or delay treatment. Treatment options include drugs and surgery.
Medications
There are two classes of drugs used for BPH treatment:
- Alpha-blockers include terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), and alfluzosin (Uroxatral)
- 5-alpha-reductase inhibitors include finasteride (Proscar) and dutasteride (Avodart)
Surgery
About 25% of men with moderate BPH symptoms, and many more men with severe symptoms, eventually need surgery. Surgery is most often required to open a blockage in the bladder outlet that causes urinary retention. There are many different surgical options ranging from invasive procedures that require open surgery and hospitalization to less-invasive procedures that can be performed on an outpatient basis.
