Why It’s Important to Treat Benign Prostatic Hyperplasia (BPH)

Benign means non-life-threatening. Prostatic means the condition is related to the prostate gland. Hyperplasia means the enlargement of an organ. Therefore, the definition of benign prostatic hyperplasia (BPH) is a non-life-threatening enlargement of the prostate gland.

Benign prostatic hyperplasia is not cancer, nor will it turn into cancer.

It is thought that approximately 50 percent of all men between ages 51 and 60 have BPH, increasing to 90 percent of men older than 80. These numbers tell us this condition is relatively common, and by the age of 70, almost all men will have some enlargement of the prostate.

Symptoms of BPH

Some men with BPH may not experience any symptoms at all. However, those who do tend to experience urinary symptoms such as:

• Urinary hesitancy (difficulty starting to urinate)
• Weak stream (difficulty maintaining the urine stream)
• Nocturia (waking up frequently at night to urinate)
• Often feeling the need to urinate or that the bladder is full (even if you have just emptied your bladder)
• Trouble stopping urinating altogether (dribbling)
• Urinary incontinence
• Urinary retention

During a man’s life, his prostate goes through two growth cycles. The first growth cycle happens during puberty, when the prostate doubles in size. The second cycle begins around age 25 and goes on for most of a man’s life. BPH occurs during the second phase of the prostate’s growth.

Left untreated, BPH can cause more severe problems. If the bladder becomes blocked due to BPH, it can lead to:

• Urinary retention
• Recurrent urinary tract infections (UTIs)
• Bladder infections
• Kidney infections
• Kidney stones
• Blood in the urine
• Kidney damage

Just because it is relatively common, and even if symptoms are mild, that does not mean you have to live with being uncomfortable. Worrying about urinary dribbling or incontinence problems can lead to other concerns, such as anxiety, and can make you fearful of socializing.

Strategize with your doctor for the best treatment so you can get back to enjoying your life.

Treatment options

Since there are other conditions with similar symptoms to BPH, your doctor will rule those out first to confirm the diagnosis. Once BPH and the severity of your symptoms are corroborated, your doctor will discuss the right treatment option for you, which may include any of the following:

Monitoring symptoms. If your symptoms are mild and not affecting your life, your doctor might decide to monitor your BPH but not actively treat it.

Lifestyle changes. If symptoms are mild, it may be possible to treat them with some basic lifestyle changes, including:

• Reducing your intake of liquids at specific times of day
• Exercising pelvic floor muscles
• Avoiding or reducing caffeinated drinks
• Avoiding or reducing alcohol
• Avoiding or monitoring the use of particular medications
• Bladder training
• Preventing or treating constipation

Prescription drugs. Your doctor can prescribe medications that can stop the growth of BPH, shrink the prostate or treat symptoms.

Minimally invasive surgery. If symptoms are moderate to severe, your doctor may recommend one of several minimally invasive surgical options:

• Prostatic urethral lift is a procedure where thin implants are inserted on either side of the prostate to make the urethra wider. This makes it easier to pass urine.
• Water vapor thermal therapy uses a special device with a retractable needle at the end. Water vapor is used to target the prostate tissue and destroy prostate cells that are squeezing the urethra.
• Transurethral electrovaporization uses a special instrument that is inserted into the urethra. The instrument heats the prostate tissue and turns it to vapor, relieving the pressure and improving urine flow.
• Transurethral incision of the prostate is a surgery where an instrument called a resectoscope is used to cut small grooves in the bladder neck to allow urine to pass through more easily.
• Transurethral resection of the prostate uses the same surgical instrument, a resectoscope, to trim away any excess prostate tissue that is blocking the flow of urine.
• Holmium laser enucleation of the prostate is a type of laser surgery used to treat the obstruction of the flow of urine.
• Thulium laser enucleation of the prostate is another type of laser surgery—very similar to holmium laser enucleation—used to treat the obstruction of the flow of urine.
• Catheterization is a process where a tube known as a urinary catheter is inserted into the bladder through the urethra to help drain away urine. This method can be used in patients who can’t tolerate surgery.

Surgery. In severe cases, your doctor may suggest that surgery is the best treatment option. For patients with large prostates, a simple prostatectomy involves removing the obstructing portion of the prostate, but not the entire prostate.

Obviously, many treatment options are available to alleviate BPH. While it’s not immediately threatening, BPH can make your life uncomfortable. Seeking advice from your doctor early can help you manage symptoms before they become too severe.