A man is at a doctor's appointment
Benign prostatic hyperplasia (BPH) is a common condition that occurs as men get older, it is sometimes referred to as an enlarged prostate.

What Is BPH?

As men get older, there is one change that’s a natural part of aging. The prostate starts to enlarge, which can lead to a common condition called benign prostatic hyperplasia (BPH). This is also referred to as an enlarged prostate or prostate gland enlargement.

The prostate is a gland that surrounds a tube called the urethra. This tube carries sperm and fluid out the penis. The urethra also carries urine out of the penis.

When you have BPH, your prostate is larger than usual. This puts pressure on the urethra which can cause a weak urine stream and can wake you up numerous times to pee. BPH has other troublesome urinary symptoms. BPH can block urine flow and can also cause urinary tract, bladder or kidney problems.

What Causes BPH?

Doctors aren’t clear why these changes occur. There is some thought that hormonal changes as men grow older might be the cause, but that’s not been proven.

The prostate grows as men get older, starting early in puberty when it doubles in size. In the mid-20s, the prostate begins growing again and continues growing during the man’s lifetime. For some men, this pattern leads to BPH.

However, specialists believe the prostate’s size won’t determine how severe the symptoms become. Slightly enlarged prostates can cause serious problems, whereas a very enlarged prostate might cause only slight urinary problems. Some men’s symptoms improve over time.

Also, some conditions can cause symptoms similar to BPH symptoms:

  • Bladder or kidney stones.
  • Bladder control problems.
  • Urinary tract infection.
  • Urethral stricture (narrowing of the urethra).
  • Prostatitis (prostate inflammation).
  • Scarring in the bladder neck (due to previous surgery).
  • Cancer of the prostate or bladder.

What Are the Symptoms of BPH?

As the prostate gets larger, it affects urine flow causing symptoms like:

  • Trouble starting urination.
  • Weak urine stream, or peeing that stops and starts.
  • Dribbling at the end.

Your bladder will have to work harder to empty the bladder, causing these symptoms:

  • Feeling a need to urinate more urgently or frequently.
  • More frequent night urination.
  • Difficulty emptying the bladder.

You may also experience:

  • Inability to urinate.
  • Blood in the urine.
  • Urinary tract infection.

BPH symptoms are different for every person. Some men have very few problems, even though they have an enlarged prostate.

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What Are the Risk Factors for BPH?

Risk factors can include:

  • Family history. If a blood relative had prostate problems, you are likely to have them. This includes your father or a brother.
  • Aging. Men younger than age 40 rarely have prostate problems. By age 60, about one-third of men have moderate to severe symptoms. By age 80, about one-half have BPH-related problems.
  • Heart disease and diabetes. Research shows that taking beta-blocker medications for heart disease can increase BPH risk. Diabetes also increases the risk.
  • Lifestyle. If you are obese, you are at increased risk of BPH. Regular exercise will help lower your risk.

Complications Related to Enlarged Prostate

Doctors don’t believe that an enlarged prostate increases the risk of developing prostate cancer. However, these complications can occur:

  • Urinary retention: This is an inability to urinate. When this occurs, your doctor may advise that you have a catheter tube inserted into your bladder to drain the urine. In some cases, surgery is required to insert the catheter.
  • Urinary tract infections (UTIs): When you cannot fully empty your bladder, this increases the risk of urinary tract infection. If you get frequent UTIs, your doctor may advise surgery to remove part of the prostate.
  • Bladder stones: These are linked with an inability to empty the bladder completely. Bladder stones can cause irritation, infection, blood in the urine and can obstruct urine flow.
  • Kidney damage: Damage to kidneys occurs when the bladder cannot empty. Retention of urine causes this damage and can also allow bladder infections to affect the kidneys.
  • Bladder damage: When the bladder can’t empty completely, over time the bladder walls can stretch and weaken. This damage further worsens the problem.

When these complications occur, they can cause very serious health problems -- especially urinary retention and kidney damage.

What Are the Treatment Options for BPH?

A variety of BPH treatments are effective in relieving symptoms of an enlarged prostate. The treatment choice will be based on several factors:

  • Your age.
  • Your overall health.
  • Size of your prostate.
  • The discomfort you are experiencing.

If your symptoms are mild, your doctor may suggest watchful waiting for several reasons:

  • Avoid the side effects of medications.
  • Less expensive than medications or surgery.
  • Mild BPH symptoms might improve without treatment.

Treatment is advised when symptoms worsen. Treatment options include prescription medications, supplements (like beta-sitosterol), and surgery. Minimally invasive surgery and traditional open surgery are two good options to discuss with your doctor.