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Enlarged Prostate (BPH)

Benign prostatic hyperplasia (BPH) is a common condition in men caused by the non-cancerous enlargement of the prostate gland. The prostate is a walnut-shaped gland that surrounds the urethra at the neck of the bladder, in front of the rectum. The main function of the prostate is to supply fluid for the semen.  As men get older, the prostate enlarges and can squeeze down on the urethra, causing lower urinary tract symptoms (LUTS) associated with BPH where men have difficulty urinating. 

SYMPTOMS:

  • A slow or weak urinary stream
  • The need to empty the bladder frequently, especially at night
  • Difficulty starting the flow of urine
  • A feeling that the bladder does not completely empty, even after urinating
  • Dribbling after urinating
  • Inability to hold the urine once the urge to urinate begins
  • Having to strain or push to force urination.

In extreme cases, you might not be able to urinate at all. This is an emergency that requires prompt attention.

RISK FACTORS:

  • Increasing age is the leading cause. More than half of men age 50 and older and 90% of men age 80 and older have BPH.
  • Family history of BPH
  • Obesity
  • Diets high in fat and animal meat intake
  • Physical inactivity

EVALUATION AND DIAGNOSTIC TESTING:

Our expert health care providers will take an in-depth health history and perform a physical exam that includes checking your prostate via a digital rectal exam (DRE). Other tests may be ordered, but are not always necessary for the initial evaluation. These include:

  • Prostate Specific Antigen (PSA) -  a blood test to screen for prostate cancer
  • Urine collection – to test for infection or to screen for bladder cancer
  • A post-void residual volume (PVR)- measures the amount of urine left in the bladder after urinating
  • Urine flow study (urolflowmetry)- measures how fast urine flows while urinating
  • Cystoscopy -  a small flexible scope that is passed through the penis to look in the urethra and/or bladder to determine if there is evidence of urethral prostate enlargement
  • Urodynamic pressure-flow study -  tests the pressures inside the bladder during urination
  • Ultrasound of the kidney or the prostate – to view the enlargement and ensure urine kidneys are not being affected by blockage.

TREATMENT:

The treatment for BPH depends on the severity of symptoms. Sometimes it is as simple as making lifestyle changes. If medicine is needed, your provider may prescribe medicine that helps relax the smooth muscles of urethra or shrink the prostate to improve your symptoms.  When medicine is not enough, surgery may be an option. Please speak with your provider to determine the correct therapy for you.