Enlarged Prostate (BPH)

Also referred to as an enlarged prostate, benign prostatic hyperplasia (BPH) is a urologic condition more likely to affect men 60 and over.

BPH affects a gland about the size of walnut that’s responsible for producing seminal fluid in males. Since the prostate gland is located by the bladder, pressure from enlarged tissues can contribute to issues with urination flow and frequency.

The approach to treatment for BPH a urologist recommends will depend on the severity of symptoms.


What Causes Benign Prostatic Hyperplasia?

It’s not clear what exactly causes the prostate gland to enlarge over time. One theory is that changes with male hormone levels may play a role in the development of BPH. Contributing factors may include having kidney stones, having a family history of prostate enlargement, and having diabetes or heart disease. Some men may develop BPH after experiencing prostate inflammation (prostatitis) or developing scars in the bladder following surgery.

Symptoms Commonly Associated with BPH

Symptoms associated with benign prostatic hyperplasia will vary based on how much pressure is placed on the bladder by the enlargement of the prostate gland. If the urethra (urine tube) is significantly compressed, BPH may contribute to kidney problems, urinary tract infections (UTIs), or severe urine obstructions. Specific symptoms associated with BPH include:

  • Frequent urination urges that often occur at night
  • Intermittent urine streams
  • Weak or trailing off urine streams
  • Difficulty beginning the urination process
  • Blood in urine

How is BPH Diagnosed?

If BPH results in a visit to a urologist, patients are usually questioned about their symptoms and medical history. In addition to a urine test, a prostate-specific antigen (PSA) blood test may be performed to check to see if levels of this substance are elevated, since this is a common result of an enlarged prostate. Some men also have a urine flow test, a digital rectal exam (DRE) to manually determine if a the prostate is enlarged, and a test that measures how well the bladder can be emptied. A biopsy may also be performed to rule out prostate cancer.

BPH Treatment Options

The type of treatment a urologist recommends will depend on the size of the prostate, coupled with a patient’s age and overall health. Standard treatment for BPH typically involves medications such as alpha blockers to relax bladder neck muscles or 5-alpha reductase inhibitors to help slow prostate growth. If symptoms are severe or not manageable with medication, surgery to remove prostate tissue, shift tissue to increase urine flow, selectively block blood flow to the prostate, or remove all or part of the prostate (prostatectomy) may be performed.

The physical enlargement of the prostate gland naturally occurs with age, so it’s not something men can entirely prevent. However, it may be possible to reduce the severity of symptoms commonly associated with benign prostatic hyperplasia with proactive diet and exercise adjustments that include eating more low-fat foods and veggies. Some men also experience fewer BPH-related problems by losing weight and performing Kegel exercises to strengthen and train pelvic floor muscles.