Benign Prostatic Hypertrophy : Causes & Treatment

Written by Medicover Team and Medically Reviewed by Dr Mayur Dalvi , Urologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Benign Prostatic Hypertrophy (BPH), commonly known as an enlarged prostate, is a prevalent condition affecting aging men. As the prostate gland enlarges, it can disrupt the normal flow of urine, leading to various urinary symptoms.

This enlargement can compress the urethra, the tube that carries urine from the bladder out of the body, causing urinary difficulties. BPH is not linked to prostate cancer, yet it can significantly impact quality of life if left unmanaged.

What Are the Causes of Benign Prostatic Hypertrophy ?

The exact cause of BPH is not well understood, but it is believed to be linked to hormonal changes as men age. Specifically, the levels of dihydrotestosterone (DHT), a hormone derived from testosterone, may increase in the prostate, prompting gland enlargement. Genetic factors and lifestyle may also play a role in the development of BPH.

What Are the Symptoms of Benign Prostatic Hypertrophy ?

The symptoms of BPH can vary in severity and may worsen over time. Common symptoms include:

Frequent urination, especially at night (nocturia)
Difficulty starting urination
Weak or interrupted urine stream
Urge to urinate
Inability to completely empty the bladder

These symptoms occur due to the pressure exerted by the enlarged prostate on the urethra, hindering normal urine flow.

When to See a Doctor for Benign Prostatic Hypertrophy ?

If you're experiencing urinary symptoms that affect your daily life, consult a urologist or primary care physician for proper evaluation. Early assessment of Benign Prostatic Hypertrophy helps prevent complications and improve quality of life through appropriate treatment options.

You should see a doctor if you have:

Frequent nighttime urination (nocturia) that disrupts your sleep pattern
Difficulty starting urination or a weak urine stream that worsens over time
Feeling that your bladder doesn't empty completely after urinating

Get medical help immediately if:

Complete inability to urinate (urinary retention) despite feeling the urge
Blood in urine accompanied by pain or fever
Severe lower abdominal pain with bladder distension

These could be signs of a serious complication like acute urinary retention, which needs urgent care.

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How is Benign Prostatic Hypertrophy Diagnosed?

Accurate diagnosis is vital for the effective management of BPH. The diagnostic process typically involves:

Medical History and Physical Examination

A comprehensive medical history will help the physician understand the patient's symptoms and any underlying conditions. A physical examination, including a digital rectal exam (DRE), allows the doctor to assess the size and condition of the prostate.

Urinalysis and Blood Tests

Urinalysis can detect infections or other conditions that may cause similar symptoms. Blood tests, such as prostate-specific antigen (PSA) levels, help rule out prostate cancer.

Additional Diagnostic Tests

Uroflowmetry: Measures the speed of urination to assess urine flow.
Postvoid Residual Volume Test: Checks how much urine remains in the bladder after urination.
Cystoscopy: A scope is inserted into the urethra to view the bladder and urethra.

What Are the Treatment Options for Benign Prostatic Hypertrophy ?

Management of BPH focuses on alleviating symptoms and improving quality of life. Treatment options vary based on symptom severity, prostate size, and patient preferences.

Lifestyle Modifications

Certain lifestyle changes can help manage BPH symptoms. These include reducing fluid intake before bedtime, limiting caffeine and alcohol, and practicing bladder training exercises.

Medications

Several medications are available to treat BPH:

Alpha-blockers: Relax the muscles of the prostate and bladder neck to improve urine flow.
5-alpha reductase inhibitors: Reduce prostate size by blocking hormonal changes that cause prostate growth.
Combination Therapy: A combination of alpha-blockers and 5-alpha reductase inhibitors can be more effective for some patients.

Minimally Invasive Procedures

For patients with moderate to severe symptoms, minimally invasive procedures can provide relief:

Transurethral Microwave Thermotherapy (TUMT): Uses microwaves to destroy excess prostate tissue.
Transurethral Needle Ablation (TUNA): Uses radiofrequency energy to shrink prostate tissue.

Surgical Options

In cases where other treatments are ineffective, surgery may be necessary:

Transurethral Resection of the Prostate (TURP): The most common surgical procedure, which involves removing part of the prostate.
Laser Surgery: Uses lasers to remove prostate tissue with minimal blood loss.

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What Is the Recovery Process for Benign Prostatic Hypertrophy?

Recovery from Benign Prostatic Hypertrophy (BPH) depends on the severity of symptoms and the type of treatment received. Many men experience significant improvement with medications, lifestyle changes, or minimally invasive procedures, while recovery after surgery varies depending on the procedure performed.

Take prescribed medications consistently to relieve urinary symptoms and prevent disease progression.
Drink adequate fluids during the day but limit fluid intake before bedtime to reduce nighttime urination.
Avoid caffeine, alcohol, and medications that may worsen urinary symptoms unless approved by your healthcare provider.
If surgery or a minimally invasive procedure was performed, follow postoperative instructions, avoid heavy lifting, and attend all follow-up appointments.
Perform pelvic floor exercises if recommended to improve bladder control and urinary function.
Contact your healthcare provider immediately if you develop severe pain, inability to urinate, heavy bleeding in the urine, fever, or signs of infection.

Frequently Asked Questions

1. What is benign prostatic hypertrophy?

Benign prostatic hypertrophy, commonly called benign prostatic hyperplasia (BPH), is a noncancerous enlargement of the prostate gland that can interfere with urine flow.

2. What are the symptoms of benign prostatic hypertrophy?

Symptoms may include frequent or urgent urination, difficulty starting urination, weak urine flow, dribbling, incomplete bladder emptying, and waking at night to urinate.

3. What causes benign prostatic hypertrophy?

The exact cause is not fully understood, but aging and hormonal changes are important factors. BPH becomes more common as men get older.

4. How is benign prostatic hypertrophy diagnosed?

Diagnosis may include a medical history, physical examination, urine tests, prostate examination, PSA testing when appropriate, and tests that measure urine flow or bladder emptying.

5. How is benign prostatic hypertrophy treated?

Treatment depends on symptom severity and may include lifestyle changes, medicines, minimally invasive procedures, or surgery for severe symptoms or complications.