A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.
Benign prostatic hyperplasia (BPH), also known as prostatic hypertrophy, is an enlargement of the prostate gland. BPH can cause problems with urination (peeing). BPH happens to all men, to some degree, as they get older.
A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.
The cause of BPH is not completely understood, although hormones, such as testosterone, may play a role.
The prostate is a small ring-shaped gland that sits just under the bladder and in front of the rectum. It surrounds the urethra, the tube that carries urine from the bladder and through the penis. When it grows larger, the prostate gland can press on the bladder and the urethra, interfering with urination.
An enlarged prostate gland can interfere with normal urination.
A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.
The final part of the large intestine, leading to the anus.
A hormone that plays a key role in the development of male sexual characteristics and reproduction. It is produced by both sexes, but in much larger amounts in men.
The duct through which urine flows from the bladder to outside the body.
The factors that increase the risk of BPH are not very clear at this stage. Family history, increasing age, being overweight or obese, diabetes, high blood pressure (hypertension) and a diet high in saturated fat and red meat have been suggested.
A metabolic disorder that is caused by problems with insulin secretion and regulation and which is characterized by high blood sugar levels. Also known as diabetes mellitus.
Symptoms of BPH can include:
These symptoms are sometimes known as lower urinary tract symptoms (LUTS).
Symptoms due to BPH often develop gradually and do not usually occur before 50 years of age. The increased size of the prostate does not always correspond to the level of symptoms you may experience.
Some serious conditions can cause similar symptoms to those of BPH. Checking in with your doctor if you have problems with urinating, or if your pattern of urination changes, can help to identify and treat these early on.
Blood in the urine is a symptom that can indicate serious health conditions that need prompt investigation.
The organs and tubes involved in transporting urine within the body and out of it.
Your doctor will ask you for details about your symptoms in order to understand how severe they are and how much they affect your lifestyle.
Your doctor may perform a digital rectal exam in order to examine the shape and size of the prostate gland. This test involves a doctor putting a gloved finger into the anus in order to examine the shape and size of your prostate gland.
Your doctor may recommend further tests or refer you to a specialist (urologist).
A blood test is used to to measure the level of prostate-specific antigen (PSA) in the blood. High PSA levels can be caused by a number of different prostate conditions including BPH, prostatitis (inflammation of the prostate) and prostate cancer.
There have been questions raised about PSA testing because PSA levels do not always reflect the risk of prostate cancer. Some men with high PSA levels do not have prostate cancer, while other men with relatively low PSA levels may have prostate cancer.
It is important to note that prostate cancer rarely causes lower urinary tract symptoms in its early stages, because it can grow within the prostate without pressing on the urethra.
Your doctor can explain more about PSA testing and discuss the potential benefits and harms of the test.
Other tests that may be recommended include:
A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.
The duct through which urine flows from the bladder to outside the body.
The organs and tubes involved in transporting urine within the body and out of it.
A physician who specializes in diagnosing and treating conditions of the urinary tract.
A cancer of the prostate, which is a gland in males that produces a fluid that is part of the semen.
Men with mild BPH may not require treatment if the symptoms do not bother them. Symptoms can sometimes improve without treatment.
A variety of treatments and self-care measures are available:
There are things you can do that can help to reduce and/or manage symptoms caused by BPH:
Bladder training involves exercises that can help to increase the amount of urine your bladder can hold before needing to urinate. Bladder training is not suitable for everyone; your doctor or urologist can advise whether it can help you.
Several types of medications can help you with the urinary flow problems that BPH causes. Once you start taking medications, you will need to continue to take them on an ongoing basis for them to be effective.
Medications include:
Alpha blockers such as prazosin and tamsulosin can help to relax muscles in the bladder and prostate, and improve urinary flow. Side effects of these drugs can include dizziness, headaches and, particularly with tamsulosin, little or no sperm when you ejaculate. They can also cause problems if you have eye surgery while taking these medications.
5-alpha-reductase inhibitors, such as dutasteride and finasteride, work by blocking the production of dihydrotestosterone (DHR). DHR is a hormone that stimulates growth of the prostate. Blocking DHR can reduce the size of the prostate gland and improve urinary symptoms.
These medications are usually only prescribed for men who have a particularly large prostate. It can take a few months for these medications to have a noticeable effect.
Common side effects of these medications can include a decreased sex drive, erectile dysfunction, and problems with ejaculation. These medications can also cause birth defects in babies if the father is taking them when the baby is conceived, or if broken or crushed tablets are handled by a pregnant woman.
Saw palmetto (also known as Serenoa repens) has been used to treat urinary symptoms associated with BPH. However, trials have not shown evidence that it is effective.
For men with severe BPH symptoms, surgery to remove some or all of the prostate may be recommended.
A small instrument called a resectoscope is inserted into the urethra. The end of the instrument (a wire loop) is used to cut away excess tissue in the region where the prostate is pressing on the urethra.
This operation is done under anesthesia. You may spend one or more nights in hospital recovering.
Transurethral resection of the prostate.
The resectoscope is used to make one or two cuts in the bladder neck, the area where the bladder and prostate connect. This can help to open up the area and increase urinary flow.
Techniques such as photoselective vaporization of the prostate (PVP) and Holmium laser enucleation of the prostate (HoLEP) are similar to TURP, but use lasers to remove the prostate tissue. These techniques are less invasive than TURP and may offer some benefits, such as reduced recovery time.
Rarely, the whole prostate may be removed. It is not commonly performed for BPH, but may be recommended if the prostate is severely enlarged.
The semen that has been ejected from the penis.
The release of semen from the penis in a single emission.
A male reproductive organ that surrounds parts of the bladder and urethra. It secretes a sperm-nourishing component of semen.
The mature male sex cell that fertilizes the female ovum.
The duct through which urine flows from the bladder to outside the body.
A physician who specializes in diagnosing and treating conditions of the urinary tract.
A group of deep muscles and ligaments at the bottom of the pelvis that support the organs that lie on it and control the anal, vaginal and urinary openings.
While BPH is unlikely to cause serious health conditions, it can sometimes lead to:
All surgeries to treat BPH can have complications. Before surgery, your urologist can discuss the potential benefits and drawbacks of the surgical techniques available, and which of them may be most suitable for you.
Complications can include:
The release of semen from the penis in a single emission.
Inability to produce offspring.
The organs and tubes involved in transporting urine within the body and out of it.
A physician who specializes in diagnosing and treating conditions of the urinary tract.
BPH does not usually cause serious health problems for men, although the symptoms can be bothersome and affect your quality of life. Generally, symptoms slowly get worse without treatment. Treatments can help to deal with symptoms, but can have significant side effects.
The lifestyle measures listed in the 'Types of treatment' section above can help to prevent or delay BPH.