What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is an enlarged prostate gland . The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.

BPH occurs in almost all men as they age. BPH is not cancer. An enlarged prostate can be a nuisance. But it is usually not a serious problem. About half of all men older than 75 have some symptoms.

Benign prostatic hyperplasia is also known as benign prostatic hypertrophy.

What causes BPH?

Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth.

What are the symptoms?

BPH causes urinary problems such as:

• Trouble getting a urine stream started and completely stopped (dribbling).
• Often feeling like you need to urinate. This feeling may even wake you up at night.
• A weak urine stream.
• A sense that your bladder is not completely empty after you urinate.

In a small number of cases, BPH may cause the bladder to be blocked, making it impossible or extremely hard to urinate. This problem may cause backed-up urine (urinary retention), leading to bladder infections or stones, or kidney damage.

BPH does not cause prostate cancer and does not affect a man's ability to father children. It does not cause erection problems.

How is BPH diagnosed?

Your doctor can diagnose BPH by asking questions about your symptoms and past health and by doing a physical exam. Tests may include a urine test (urinalysis) and a digital rectal exam, which lets your doctor feel the size of your prostate. In some cases, a prostate-specific antigen (PSA) test is done to help rule out prostate cancer. (Prostate cancer and BPH are not related, but they can cause some of the same symptoms.)

Your doctor may ask you how often you have symptoms of BPH, how severe they are, and how much they affect your life. If your symptoms are mild to moderate and do not bother you much, home treatment may be all that you need to help keep them under control. Your doctor may want to see you regularly to check on your symptoms and make sure other problems haven't come up.

You can use this tool to help you think about how bothersome your symptoms are:

Interactive Tool: How Bad Are Your Urinary Symptoms From Benign Prostatic Hyperplasia (BPH)?

How is it treated?

As a rule, you don't need treatment for BPH unless the symptoms bother you or you have other problems such as backed-up urine, bladder infections, or bladder stones.

Although home treatment cannot stop your prostate from getting larger, it can help reduce or control your symptoms. Here are some things you can do that may help reduce your symptoms:

• Practice "double voiding." Urinate as much as you can, relax for a few moments, and then urinate again.
• Avoid caffeine and alcohol. They make your body try to get rid of water and can make you urinate more often.
• If possible, avoid medicines that can make urination difficult, such as over-the-counter antihistamines, decongestants (including nasal sprays), and allergy pills. Check with your doctor or pharmacist about the medicines you take.

If home treatment does not help, BPH can be treated with medicine. Medicine can reduce the symptoms, but it rarely gets rid of them. If you stop taking medicine, symptoms return.

If your symptoms are severe, your doctor may suggest surgery to remove part of your prostate. But few men have symptoms or other problems severe enough to need surgery.

Can BPH be prevented?

You cannot prevent BPH or the urination problems it may cause. Some people believe that regular ejaculations will help prevent prostate enlargement. But there is no scientific proof that ejaculation helps.

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