Benign Prostatic Hypertrophy (BPH)

Benign Prostatic Hyperplasia (Enlarged Prostate)

Emergency Medicine,Genitourinary

Written by the doctors and editors at UpToDate
What is benign prostatic hyperplasia? — "Benign prostatic hyperplasia" is the medical term for an enlarged prostate. The prostate is a gland that surrounds the urethra (the tube that carries urine from the bladder out through the penis) (figure 1). This gland often gets bigger in men as they get older.
Benign prostatic hyperplasia, also called "BPH," is a common problem. It has nothing to do with prostate cancer. In fact, the word "benign" means "not cancer."
What are the symptoms of BPH? — Many men with BPH have no symptoms at all. When symptoms do occur, they can include:
Needing to urinate often, especially at night
Having trouble starting to urinate (this means that you might have to wait or strain before urine will come out)
Having a weak urine stream
Leaking or dribbling urine
Feeling as though your bladder is not empty even after you urinate
In rare cases, BPH makes it so a man cannot urinate at all. This is a serious problem. If you cannot urinate at all, call your doctor right away.
Is there a test for BPH? — Yes. Your doctor can check for BPH by doing a rectal exam. That means that he or she will put a finger into your anus to check how big your prostate is and what it feels like (figure 2). Your doctor might also do urine or blood tests to see if your symptoms might be caused by another problem, such as a bladder infection.
Is there anything I can do on my own to feel better? — Yes. You might be able to improve your BPH symptoms by:
Reducing the amount of fluid you drink, especially just before bed
Limiting the amount of alcohol and caffeine you drink. These drinks can make you urinate more often.
Avoiding cold and allergy medicines that contain antihistamines or decongestants. These medicines can make the symptoms of BPH worse.
Doing something doctors call "double voiding." That means that after you empty your bladder, you wait a moment, relax, and try to urinate again.
Should I see a doctor or nurse? — If you have symptoms like the ones listed above, see your doctor or nurse to find out if BPH is really what's causing them. Those symptoms can be caused by other problems, so it's important to have them checked out.
If you do have BPH, your doctor can offer you different treatment options. But you don't have to get treated if your symptoms do not bother you. Unless you lose the ability to urinate completely, leaving BPH untreated will not hurt you.
How is BPH treated? — Treatments options include:
Watchful waiting – Watchful waiting means that you wait to see if your symptoms change, but you don't have treatment right away. Men who choose this option can decide to try treatment later if their symptoms get worse or if their symptoms start to bother them more.
Medicines – There are two types of medicine commonly used to treat BPH. One type relaxes the muscles that surround the urethra. The other type keeps the prostate from growing more or even helps the prostate shrink. In some cases, doctors suggest taking both types of medicine at the same time. Depending on your symptoms, your doctor might also suggest other medicines.
Surgery – Surgery to treat BPH works by removing some of the prostate or by causing the prostate to shrink. There are several surgeries to choose from.
How do I choose which treatment to have? — The right treatment for you will depend on:
How much your symptoms bother you
How you feel about the different treatment options
If your symptoms don't bother you very much, you might not need any treatment. On the other hand, if your symptoms do bother you, you probably should get treated.
Doctors often suggest trying medicines first to see if they help. If medicines don't do enough, surgery is also an option. As you think about your choices, remember that treatments can have a downside. Medicines can cause side effects, for example. And surgery has some general risks, and can also sometimes cause sexual problems and other side effects.
When you're thinking about which treatment to have, ask your doctor or nurse these questions:
How likely is it that this treatment will improve my symptoms?
What are the risks or side effects of this treatment?
What happens if I don't have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15355 Version 14.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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