BPH (Benign Prostatic Hyperplasia) | Urology | Loyola Medicine

BPH (Benign Prostatic Hyperplasia)

Overview and Facts about BPH (Benign Prostatic Hyperplasia)

Benign prostatic hyperplasia (BPH) is a urology condition also known as prostate gland enlargement, benign prostatic hypertrophy or benign prostatic obstruction. The prostate gland, a walnut-shaped gland responsible for making semen, or sperm fluid, is part of the reproductive system. It surrounds both the urethra and the neck portion of the bladder. In BPH, persistent prostate gland growth leads to a compressed or pinched urethra and a thick and weakened bladder wall, disrupting the normal emptying of urine from the bladder. Thus, BPH is known for causing uncomfortable urinary tract issues in men.

Signs and Symptoms of BPH (Benign Prostatic Hyperplasia)

The major sign and symptom of BPH is a frequent urge to urinate. This urge or increased frequency tends to increase or occur at night, in a condition called nocturia. Urination is also difficult in men with BPH, as the disease causes a weak urine stream that starts and stops. In severe cases, signs and symptoms include blood in the urine, bladder infection and an inability to urinate. Prostate-specific antigen (PSA) levels also increase in the blood when the prostate is enlarged.

Signs and symptoms of BPH include:

  • Small traces of blood in the urine
  • Difficulty starting and completing urination
  • Pain after ejaculation and/or urination
  • Urine retention
  • Urinary incontinence or bed-wetting
  • Sexual dysfunction

Causes and Risk Factors of BPH (Benign Prostatic Hyperplasia)

The causes of BPH are not well understood. However, it is currently understood that in BPH the prostate gland enlargement is not due to cancer or tumor growth but rather to naturally occurring prostate growth that occurs with age. Specifically, the prostate enters its second major growth phase at 25 years of age and thereafter. As the prostate enlarges, it presses against the urethra and bladder to cause signs and symptoms of BPH.

Other risk factors of BPH include:

  • Bladder infection
  • A narrowed urethra
  • Bladder scarring that can occur after bladder surgery
  • Bladder stones

Tests and Diagnosis of BPH (Benign Prostatic Hyperplasia)

There are many ways to test and diagnose BPH. A physical exam is usually the first step taken to identify obvious or physical signs of BPH. Imaging tests, such as ultrasounds, CT scans or MRIs, are used to examine the size of the prostate gland and extent of urethra blockage and bladder thickening. Laboratory blood tests are also performed to look for chemical signs of BPH, such as increased PSA levels. Urine tests are performed to rule out the possibility of bladder infection. A urine flow study measures the pressure at which urine empties naturally from the bladder. A cystoscopy exam is performed to examine the state of the bladder and urethra.

Treatment and Care for BPH (Benign Prostatic Hyperplasia)

Treatment for BPH largely depends on age, prostate size, overall health, and level of discomfort. BPH is treated with medications (alpha blockers and phosphodiesterase-5 inhibitors), minimally invasive procedures (prostatic water vapor therapy) and surgery (laser surgery and open prostatectomy). BPH is preventable through diet and exercise, thus men are encouraged to adopt diet and lifestyle habits that could decrease the risk of BPH.