What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, affects almost all men aged 50 or older. With BPH, there’s an overgrowth of prostate tissue that pushes against the urethra and the bladder, restricting the flow of urine.
It’s important to remember that the “B” in BPH stands for “benign”—BPH is not cancer.
BPH Symptoms
An enlarged prostate alone may or may not cause symptoms (and the size of the prostate doesn’t necessarily equate to the degree of urinary symptoms). However, an increase in the number or intensity of bothersome symptoms is the most common reason men seek treatment.
- A weak or slow urinary stream
- A feeling of incomplete bladder emptying
- Difficulty starting urination
- Frequent urination
- Urgency to urinate
- Getting up frequently at night to urinate
- A urinary stream that starts and stops
- Straining to urinate
- Continued dribbling of urine
- Returning to urinate again minutes after finishing
Do you experience any of these symptoms?
BPH Diagnosis
Doctors use a variety of tests to diagnosis men have BPH. These tests help determine how severe the patient’s condition is, rule out other possible causes, and assess a patient’s overall condition.
These tests may need to be carried out more than once to get the most-accurate diagnosis possible.
Questionnaire
The severity and type of symptoms you have and how much they bother you or impact your life can all help your doctor with your diagnosis. A simple questionnaire called the International Prostate Symptom Score (IPSS) is a common starting point.
Urine Flow Study
A patient empties his bladder, and the amount and speed of urine flow are measured. A special device can help physicians detect reduced urine flow associated with BPH.
DRE Exam
The digital rectal exam (DRE) test is performed by a doctor using their gloved index finger to feel your prostate through the rectal wall to assess its size, shape and stiffness.
PSA Blood Test
Prostate Specific Antigen (PSA) is a protein made only by the prostate gland. The amount of PSA measured in your blood normally increases with age and prostate size, but abnormally high levels may indicate the need for additional testing.
What are the most common BPH treatments?
Watchful Waiting
For relatively mild symptoms, your doctor will often recommend a “wait-and-see-approach” that may include imaging such as an ultrasound of your bladder and kidneys.
Medication
Medication is the most common treatment for mild to moderate BPH. The most prescribed types of drugs are alpha blockers and 5-alpha reductase inhibitors.
TULSA PROCEDURE
An advanced, minimally invasive treatment tailored to your specific prostate and level of BPH. Real-time MRI imaging helps your doctor see and treat your prostate in real time for greater accuracy.
First-line Intervention Treatment (FIT)/Minimally Invasive Surgical Treatment (MIST)
Minimally invasive BPH treatments that may be tried between medication and surgery use a range of technologies from balloons to steam.
Surgery (TURP, HoLEP)
For many years the most common BPH treatment, transurethral resection of the prostate (TURP) is performed by a resectoscope or laser (aka “laser TURP”).
Do you have BPH?
The questions in this assessment are based on the International Prostate Symptom Score (IPSS), a tool used by doctors to better understand the severity of urinary symptoms related to prostate health. While this assessment doesn’t provide a diagnosis or medical advice, your results can help guide a meaningful discussion with your doctor.
You can print your results and bring them to your appointment—they’re a helpful starting point when exploring options like the TULSA Procedure.
Looking for more information?
Both the NIH’s NIDDKD and American Urological Association’s Urology Care Foundation™ have a wide range of helpful BPH information.
Learn more about prostate conditions
Prostate cancer
Prostate cancer is a problematic change in prostate tissue. The prognosis depends on how far the cancer has spread at the time of diagnosis.
Radio-Recurrent Prostate Cancer
When radiation therapy fails to eliminate prostate cancer completely, it’s called recurrent prostate cancer. This is a serious health risk for approximately 20%-30% of radiation-treated patients.