Throughout a man’s life, his prostate may become larger and start to cause problems as he ages. But what are some of those problems? How do I know if I have Benign Prostatic Hyperplasia (BPH)? When should I see a urologist? What kinds of tests will my urologist perform?
Georgia Urology has access to the most current information and offers the latest diagnostic and treatment modalities for BPH in our office throughout the Atlanta metro area.
The following should help answer these questions as well as others.
What Is BPH?
Benign prostatic hyperplasia (BPH) is a common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. As the prostate enlarges, it can squeeze down on the urethra. This can cause men to have trouble urinating leading to the symptoms of BPH. Risk factors for developing BPH include increasing age and a family history of BPH.
Symptoms of BPH?
Many men with benign prostate hyperplasia have no symptoms. When symptoms occur, they may range from mild and barely noticeable to serious and disruptive. The amount of prostate enlargement is not always related to the severity of the symptoms. Some men with only slight enlargement have serious symptoms, and some men with a great deal of enlargement have few symptoms. Since the prostate surrounds the urethra just below the bladder, its enlargement can result in symptoms that irritate or obstruct the bladder.
Difficulty starting urine stream (hesitancy and straining).
Decreased strength of the urine stream (weak flow).
Dribbling after urination.
Feeling that the bladder is not completely empty.
An urge to urinate again soon after urinating.
Pain during urination (dysuria).
Waking at night to urinate (nocturia).
Frequent urination.
A sudden, uncontrollable urge to urinate.
In extreme cases, a man might not be able to urinate at all, which is an emergency that requires prompt attention.
How is BPH Diagnosed?
In order to help assess the severity of such symptoms, the American Urological Association (AUA) BPH Symptom Score Index was developed. This diagnostic system includes a series of questions that ask how often the urinary symptoms identified above occur. This helps measure how severe the BPH is, ranging from mild to severe.
Evaluation for Possible BPH
The evaluation will typically consist of a thorough medical history, a physical examination (including a digital rectal exam or DRE), and the use of the AUA BPH Symptom Score Index. In addition, the urologist will generally do a urine test called a urinalysis. There are a series of other studies that may or may not be offered to a patient being evaluated for BPH depending on the clinical situation. These include:
Prostate-specific antigen (PSA), is a blood test to screen for prostate cancer.
Urinary cytology is a urine test to screen for bladder cancer.
Measurement of post-void residual volume (PVR), the amount of urine left in the bladder after urinating.
Uroflowmetry, or urine flow study, is a measure of how fast urine flows when a man urinates.
Cystoscopy is a direct look at the urethra and/or bladder using a small flexible scope.
Urodynamic pressure-flow study that tests the pressures inside the bladder during urination.
Ultrasound of the kidney or the prostate.
When Should I See a Urologist About BPH?
You should see your urologist if you have any of the symptoms mentioned previously that are bothersome. In addition, you should see your urologist immediately if you have blood in the urine, pain with urination, burning with urination, or are unable to urinate.
Treatments Available for Enlarged Prostate or BPH?
BPH treatment decisions are based on individual conditions. Your urologist will discuss the pros and cons of each option during your BPH treatment planning. Treatment options for enlarged prostate, or benign prostatic hyperplasia (BPH), may include the following:
Lifestyle & Medical
Dietary changes (e.g., reducing evening intake of fluids, eliminating bladder irritants such as caffeine and alcohol from the diet).
Bathroom habits (e.g., regular urination cycles).
Exercise (e.g., and regular moderate exercise).
Medications (e.g., alpha-blockers).
Minimally Invasive Treatments
iTind: a relatively new BPH treatment that reshapes and widens the urethral opening using a small, biocompatible, and temporarily implanted device.
Optilume: a drug-coated balloon indicated for treating anterior urethral strictures.
No, it is very common. It will affect approximately 50 percent of men between the ages of 51 and 60 and up to 90 percent of men over 80.
Does BPH Lead to Prostate Cancer?
No, BPH is not cancer and cannot lead to cancer, although both conditions can exist together. There are usually no symptoms during the early stages of prostate cancer, so yearly physical examinations and PSA tests are highly recommended to eliminate cancer diagnosis.
Are There Risks in Not Seeking Treatment for BPH?
In the majority of men, BPH is a progressive disease. It can lead to bladder damage, infection, blood in the urine, and even kidney damage. It is therefore important for men with this condition to continue to be followed.
Which Type of Drugs Are the Best?
To date, there is not enough research data to predict who will respond to medical therapy or which drug will be better for an individual patient. There is a variety of drugs available and, in some men, a combination of drugs may work best.
How Do I Know if Oral Medications Are the Best Treatment for Me?
If you are diagnosed with BPH, you should discuss all treatment options with your urologist. Together, you and your doctor can decide whether medication, minimally invasive therapy, or surgical treatment is best for you.
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