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What is BPH?

Benign prostatic hyperplasia (BPH) is non cancerous growth of the  prostate. The prostate is a sexual organ and starts to grow during puberty.  As you age, your prostate typically get larger. Eventually the growth develops into BPH. As the prostate enlarges, it can start to compress your urethra and cause urinary symptoms. About half of all men between the ages of 51 and 60 have BPH and  90% of men over age 80 have BPH.

What is the prostate?

The prostate is part of the male reproductive system. It is about the size of a walnut and weighs about an ounce.  The prostate goes all the way around a tube called the urethra. The urethra carries urine from the bladder, through the prostate  out through the penis. The main job of the prostate is to make fluid that helps the sperm get to the woman’s egg for conception. During ejaculation, sperm and fluid from the prostate is expelled out the penis.

What are the symptoms of BPH?

  • The need to urinate at night
  • Feeling of incomplete emptying
  • Urgent sense to urinate
  • Weak urine flow
  • Dribbling of urine
  • The need to stop and start urinating several times
  • Trouble starting to urinate
  • Straining while urinating

Occasionally, you might not be able to urinate at all. This is called urinary retention.  This is an emergency and must be treated right away.


What does it mean if I have a large prostate?

The size of your prostate doesn’t necessarily mean your symptoms will be worse. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.  Urinary symptoms may stay the same, however they typically worsen over time.

What other conditions can cause urinary symptoms that mimic BPH?

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

  • Urinary tract infection
  • Inflammation of the prostate (prostatitis)
  • Scarring of the urethra (urethral stricture)
  • Scarring in the bladder neck as a result of previous surgery
  • Bladder or ureteral stones
  • Neurologic disorders
  • Cancer of the prostate or bladder

What are the risk factors for BPH?

Risk factors for prostate gland enlargement include:

  • Aging. Prostate gland enlargement rarely causes signs and symptoms in men younger than age 40. About one-third of men experience moderate to severe symptoms by age 60, and about half do so by age 80.
  • Family history. Having a blood relative, such as a father or brother, with prostate problems means you’re more likely to have problems.
  • Ethnic background. Prostate enlargement is less common in Asian men than in white and black men. Black men might experience symptoms at a younger age than white men.
  • Diabetes and heart disease. Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.
  • Lifestyle. Obesity increases the risk of BPH, while exercise can lower your risk.

What are the risks of BPH?

Untreated BPH can lead to many of the conditions outlined in the indications for treatment section outlined below.  Initially there may be a progression in urinary symptoms and urinary bother causing a decrease in quality of life. Additional risks include urinary retention, urinary tract infections, bladder stones, prostate bleeding and decreased bladder function from prolonged retention and in severe cases kidney damage from chronic retention.

What are the indications for treatment of BPH?

Traditional indications for treatment include recurrent urinary retention, recurrent urinary tract infections,  recurrent prostate bleeding, bladder stones, renal insufficiency due to bladder outlet obstruction.

Relative indications include significant lower urinary tract symptoms (LUTS) and symptoms with intolerance of medications.

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