Understanding BPH: What is It, and Should I Be Worried?

Enlarged ProstateARE YOU HAVING URINARY SYMPTOMS AND THINK YOU HAVE BPH?

If so, the first thing you need to know is, don’t panic! BPH is not cancer. Benign prostatic hyperplasia (also called benign prostatic hypertrophy or BPH) simply means that you have symptoms consistent with an enlarged prostate. Let’s talk about what that means for you — the causes, symptoms, and treatment options we offer.

WHAT CAUSES BPH?

The prostate is a gland that’s located under your bladder. Its main job is to provide the fluid in semen. The urethra, the tube that carries urine from your bladder to your penis, runs through the middle of your prostate. To oversimplify the issue, BPH symptoms happen when the prostate grows larger and pinches the urethra, narrowing the tube and blocking urine flow. The pressure continues to build up in the bladder as time goes on and causes damage and thickness to the bladder wall.

Several factors can put you at risk for BPH symptoms.

  • Age. Many men don’t realize that the prostate can grow throughout life. An enlarged prostate is common in men over 50. By age 60, about 50% of men will have BPH symptoms. By age 80, about 90% will experience them.
  • Family history. BPH can run in families. If your father or brother has BPH, you are more likely to have it yourself.
  • Other health conditions. patients on Testosterone replacement therapy are at risk of further growth of the prostate.
  • Erectile dysfunction (ED). While ED doesn’t cause BPH (or vice versa), the two conditions may occur together.
  • Lifestyle. As with many health conditions, exercise can lower your risk for BPH symptoms, and obesity can increase it.

Some of these risk factors are out of your control, of course, like age and family history. But others can be reduced by healthy diet and exercise choices.

WHAT ARE THE SYMPTOMS OF BPH?

Even with the healthiest lifestyle, many men will begin to notice the first BPH symptoms around age 50. Here’s what to look out for:

  • Needing to go urgently or more often.
  • Needing to go often during the night.
  • Needing to strain or push to start flow.
  • A weak stream or one that starts and stops.
  • Dribbling after you go.
  • A feeling that you can’t fully empty your bladder.

The best place to start is the IPSS questionnaire. This is where we can assess all of the issues and evaluate the next course of action. Sometimes, symptoms of prostatitis can overlap with BPH issues, but BPH won’t occur overnight. Men with BPH symptoms begin developing symptoms that increase in severity over months to years, but it’s important to find the problem early before the bladder becomes thickened and damaged.

POTENTIAL COMPLICATIONS

Although BPH is “benign” and not cancer, it can cause other health problems if not treated. These can include:

  • Bladder thickening with subsequent damage to the bladder.
  • Urinary tract infection (UTI).
  • Bladder stones.
  • Kidney damage.
  • Blood in your urine (hematuria).
  • A sudden inability to urinate (urinary retention).

These complications of BPH can be serious so it is always best to get evaluated before you end up in the emergency room with a nurse placing a catheter in your urine channel ;-).

diagnose enlarged prostateHOW IS BPH DIAGNOSED?

If you suspect you have BPH, start with the BPH or IPSS score. This stands for the International Prostate Symptom Index Score and is a validated questionnaire. Think, “I pee super slow” as a mnemonic to remember the name of the questionnaire. If you are a man in Dr. Bevan-Thomas’s clinic, you will be handed this questionnaire almost every time you arrive in the clinic. Yes, it’s that important!!

Depending on your physical exam and responses to the IPSS score, Dr. B-T may order any or all of the following:

  • Urinalysis to test your urine in the lab to ensure there is not an infection.
  • PSA blood test.
  • Ultrasound of your prostate.
  • Cystoscopy, a procedure that uses a scope to look at the bladder or urethra.
  • Post-void residual, which measures urine still in your bladder after you urinate.
  • Urocuff procedure, which measures how fast your urine is flowing.
  • Urodynamic pressure, which tests pressure in the bladder while you urinate.

These diagnostic tests will give Dr. Bevan-Thomas a better idea of the seriousness of your BPH. Depending on a man’s symptoms and the size of his prostate will dictate the next steps. Most men will get a prostate ultrasound at some point during their evaluation of their BPH issues. This is extremely important in modern Urology as the treatments vary according to the size of the prostate and the symptoms they are having.

Urologist Dr. Richard Bevan-Thomas of Urology Partners
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