Benign Prostatic Hyperplasia

A noncancerous enlargement of the prostate that may cause difficulty in urination. Experts do not yet know what causes BPH, but the condition may be related to the hormone testosterone and its relationship to other hormones that changes during the aging process. The fact that the prostate begins to grow larger is not necessarily a problem. In fact, some men have extremely enlarged prostates but suffer no ill effects. On the other hand, some men have prostates that are only slightly enlarged and they suffer from bothersome urinary symptoms.

Signs & Symptoms

• Trouble starting to urinate.
• A weak urine stream that can start and stop, or only urinating a little bit.
• Needing to urinate more often and/or get out of bed a few times at night to urinate.
• Leaking or dribbling urine after going to the bathroom.
• Feeling like the bladder has not been emptied.
• Having a strong, sudden urge to pass urine.

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Treatment Options

• Active Surveillance-This is common for men with mild symptoms.  Active surveillance means monitoring the problem with a doctor to keep a watchful eye on it through regular check-ups. 
• Medication-There are two types of medicines to help enlarged prostate symptoms.
  • Relax muscles in the bladder and around the urethra.  These medicines, known as Alpha-blockers, have been able to help urinary symptoms in men.  Alpha-blockers do not stop or slow down the enlargement of the prostate.  They have also been known to have side effects such as dizziness, ejaculation problems, stomach problems, tiredness, low blood pressure and headaches.
  • Shrink the prostate.  These medicines, known as 5-Alpha-reductase inhibitors, lower the amount of hormone involved in prostate growth.  These medications take longer to reduce symptoms.  However, men taking these medications are less likely to have a blocked bladder and are less likely to need surgery.  The known side effects to these medications are trouble having an erection, lowered sex drive, less semen when you ejaculate and male breast growth.
• Surgery-If symptoms are severe the physician may suggest surgery.  There are a couple types of surgery for BPH.
  • Remove the enlarged part of the prostate.  This procedure is called transurethral resection of the prostate (TURP).  It is the most common approach.  There is a risk of side effects including a decline in sexual function and a loss of bladder control. 
  • Remove the prostate.  This is a major surgery that is typically only done on men with very large prostates.  There is a risk of losing bladder control and experiencing sexual side effects.  More treatment is rarely needed after having this procedure.