Benign prostatic hyperplasia (BPH): Causes-Symptoms-Diagnosis-Treatment

 What is Benign prostatic hyperplasia (BPH)?

Prostate enlargement (BPH) is a condition in which the prostate grows in size. The prostate surrounds part of the urethra, which is the tube that carries urine and sperm out of the body. BPH is considered to be non cancerous, but it can still cause problems. BPE is a common condition that is sometimes called benign prostatic enlargement.

The prostate is located below the bladder and in front of the rectum. If the prostate becomes enlarged, it can prevent urine or semen from passing through the urethra.

What is Benign prostatic hyperplasia (BPH)
Benign prostatic hyperplasia

The main purpose of the prostate is to produce fluid for semen. This fluid contains sperm and testosterone, which helps during puberty when testosterone levels increase. Semen production occurs when fluid is released.

BPH is the most common problem with the prostate in men. Almost all men will develop some enlargement of the prostate as they grow older. By age 60, 50% of men will have signs of BPH; by age 85, 90% of men will have signs of the condition. About half of these men will develop symptoms that require treatment. The leaves will be treated.

Does having benign prostatic hyperplasia (BPH) increase the risk of prostate cancer? BPH is a condition in which the prostate enlarges and becomes difficult to empty. Some scientists believe that BPH may increase the risk of developing prostate cancer. However, this has not been proven conclusively.

Based on research to date, it does not appear that having BPH increases the risk of developing prostate cancer. However, since BPH and prostate cancer share similar symptoms, a man with BPH may also have undiscovered prostate cancer at the same time.

The American Urological Association and the American Cancer Society recommend that men ages 55 to 69 get a prostate screening every year. They also say that men who are at high risk, such as African-American men and men who have a family history of prostate cancer, should get screened more often. Prostate cancer screening can begin at age 40. A blood test for a substance called prostate-specific antigen (PSA) and the digital rectal exam (DRE) are used to screen for this disease.

  1. Male reproductive system

  • Internal reproductive organs

  1. Testes

  2. Epididymis

  3. Vas deferens

  4. Seminal vesicles

  5. Prostate

  6. Bulbourethral glands

  • External reproductive organs

  1. Penis

  2. Scrotum

Medical terms 

Benign ductless gland dysplasia (BPH) — conjointly known as prostate enlargement — may be a common condition as men grow up. An enlarged prostate will cause uncomfortable urinary symptoms, like obstruction of the flow of piddle out of the bladder. It may also cause bladder, tract or excretory organ issues.

There are many effective treatments for prostate enlargement, as well as medications, minimally invasive therapies and surgery. To settle on the most effective choice, you and your doctor can take into account your symptoms, the scale of your prostate, different health conditions you would possibly have and your preferences.

The prostate gland is a small walnut-shaped organ located just under the bladder and surrounding the urethra in men The main function of the prostate is to produce fluid that nourishes and protects sperm As men age their prostate continues to grow in size which can eventually cause problems with urinary flow and lead to an enlarged prostate (benign prostatic hyperplasia – BPH).

Benign prostatic hyperplasia (BPH) or simply prostate enlargement is the swelling of tissues in the male reproductive system and may include symptoms such as weak urinary stream prolonged urination painful urination frequent need to urinate and incomplete emptying of one's bladder Most men begin experiencing BPH symptoms during their 50s or 60s; however some men experience these symptoms during their 40s In rare cases when it progresses rapidly without treatment BPH can lead to urinary retention and kidney failure Medications are a widely used treatment for prostate enlargement; however many people prefer natural remedies.

Symptoms Benign prostatic hyperplasia

The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:

  • Frequent or urgent need to urinate

  • Increased frequency of urination at night (nocturia)

  • Difficulty starting urination

  • Weak urine stream or a stream that stops and starts

  • Dribbling at the end of urination

  • Inability to completely empty the bladder

Less common signs and symptoms include:

  • Urinary tract infection

  • Inability to urinate

  • Blood in the urine

The size of your prostate does not essentially confirm the severity of your symptoms. Some men with solely slightly enlarged prostates will have important symptoms, whereas different men with terribly enlarged prostates will have solely minor urinary symptoms.

In some men, symptoms eventually stabilize and may even improve over time.

Other possible causes of urinary symptoms

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

  • Urinary tract infection

  • Inflammation of the prostate (prostatitis)

  • Narrowing of the urethra (urethral stricture)

  • Scarring in the bladder neck as a result of previous surgery

  • Bladder or kidney stones

  • Problems with nerves that control the bladder

  • Cancer of the prostate or bladder

When to see a doctor

If you are having urinary issues, discuss them together with your doctor. Though you do not realize urinary symptoms are plaguey, it is vital to spot or rule out any underlying causes. Untreated, urinary issues would possibly result in obstruction of the tract.

If you are unable to pass any excrement, ask for immediate medical attention.

Our caring team of Clinic consultants will assist you together with your health issues. Visit the Mayonnaise Clinic men's room Health to start.

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Causes Benign prostatic hyperplasia (BPH)

The ductless gland is found below your bladder. The tube that transports piss from the bladder out of your erectile organ (urethra) passes through the middle of the prostate. Once the prostate enlarges, it begins to dampen piss flow.

Most men have continued prostate growth throughout life. In several men, this continued growth enlarges the prostate enough to cause urinary symptoms or to considerably block piss flow.

Based on research to date, it does not appear that having BPH increases the risk of developing prostate cancer. However, since BPH and prostate cancer share similar symptoms, a man with BPH may also have undiscovered prostate cancer at the same time.

The American Urological Association and the American Cancer Society recommend that men ages 55 to 69 get a prostate screening every year. They also say that men who are at high risk, such as African-American men and men who have a family history of prostate cancer, should get screened more often. Prostate cancer screening can begin at age 40. A blood test for a substance called prostate-specific antigen (PSA) and the digital rectal exam (DRE) are used to screen for this disease.

Risk factors Benign prostatic hyperplasia

Risk factors for prostate gland enlargement include:

  • Aging. Prostate gland enlargement seldom causes signs and symptoms in men younger than age forty. a simple fraction of men experience moderate to severe symptoms by age sixty, and concerning 0.5 do therefore by age eighty. 

  • Family history. Having a blood relative, such as a father or a brother, with prostate problems means you're more likely to have problems.

  • Diabetes and heart disease. Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.

  • Lifestyle. Obesity increases the risk of BPH, while exercise can lower your risk.

Complications Benign prostatic hyperplasia

Complications of an enlarged prostate can include:

  • Sudden inability to urinate (urinary retention). You might have to have a tube (catheter) inserted into your bladder to empty the body waste. Some men with an associate degree enlarged prostate want surgery to alleviate retentivity. 

  • Urinary tract infections (UTIs). Inability to fully empty the bladder can increase the risk of infection in your urinary tract. If UTIs occur frequently, you might need surgery to remove part of the prostate.

  • Bladder stones. These square measures are typically caused by associate degree inability to fully empty the bladder. Bladder stones will cause infection, bladder irritation, blood within the water and obstruction of water flow. 

  • Bladder damage. A bladder that hasn't emptied completely can stretch and weaken over time. As a result, the muscular wall of the bladder no longer contracts properly, making it harder to fully empty your bladder.

  • Kidney damage. Pressure within the bladder from retention will directly injury the kidneys or permit bladder infections to achieve the kidneys.
    Most men with an associate degree enlarged prostate do not develop these complications. However, acute retention and urinary organ injury will be serious health threats.
    Having an associate degree enlarged prostate isn't believed to extend your risk of developing glandular carcinoma. 

Mesotherapy is an innovative treatment for BPH (enlarged prostate) this natural therapy includes the use of various substances such as Mesobolone – a patented plant extract fibrin and hyaluronic acid that replenishes the hydrolipidic matrix The best part of mesotherapy is that it could be completed in just one session lasting only 10-30 minutes while other techniques may involve several sessions over a period of months The procedure involves the introduction of micro and nano particles into the affected areas directly by ultrasound or by intracorporeal injections; which are then absorbed by local cells where.

Prostate hyperplasia aka prostate enlargement is a common condition experienced by men over the age of 50. It's among the most common reasons older men are treated with drugs along with high cholesterol and high blood pressure Prostate enlargement is actually normal in older men; in fact that's why some men can father children into their 60s and 70s However sometimes it interferes with daily life so much that drug treatment is prescribed to control it.

Diagnosis Benign prostatic hyperplasia

Your doctor will look at your medical history and do a physical examination. This includes checking your health status and bodily functions.

A doctor will insert a gloved finger into your rectum to feel your prostate and detect any areas that may be cancerous.

Your doctor will start by asking detailed questions about your symptoms and doing a physical exam. This initial exam is likely to include:

  • Digital rectal exam. The doctor inserts a finger into the rectum to check your prostate for enlargement.

  • Urine test. Analyzing a sample of your urine can help rule out an infection or other conditions that can cause similar symptoms.

  • Blood test. The results can indicate kidney problems.

  • Prostate-specific antigen (PSA) blood test. PSA could be a substance created in your prostate. prostate specific {antigen|PSA|protein} levels increase after you have an enlarged prostate. However, elevated prostate specific antigen levels may ensue to recent procedures, infection, surgery or glandular cancer.
    After that, your doctor may advocate extra tests to assist make sure Associate in Nursing enlarged prostate and to rule out alternative conditions. These tests include: 

  • Urinary flow test. You urinate into a receptacle attached to a machine that measures the strength and amount of your urine flow. Test results help determine over time if your condition is getting better or worse.

  • Postvoid residual volume test. This check measures whether or not you'll be able to empty your bladder utterly. The checks are often done using ultrasound or by inserting a tube into your bladder once you urinate to see what quantity weewee is left in your bladder. 

  • 24-hour voiding diary. Recording the frequency and amount of urine might be especially helpful if more than one-third of your daily urinary output occurs at night.

If your condition is more complex, your doctor may recommend:

  • Transrectal ultrasound. An ultrasound probe is inserted into your rectum to measure and evaluate your prostate.

  • Prostate biopsy. Transrectal ultrasound guides needles accustomed to take tissue samples (biopsies) of the prostate. Examining the tissue will facilitate your doctor diagnose or rule out glandular cancer. 

  • Urodynamic and pressure flow studies. A tube is rib through your epithelial duct into your bladder. Water — or, less normally, air — is slowly injected into your bladder. Your doctor will then live bladder pressure and verify however well your bladder muscles are operating. These studies are sometimes used solely in men with suspected medicine issues and in men UN agencies have had a previous prostate procedure and still have symptoms. 

  • Cystoscopy. A lighted, flexible instrument (cystoscope) is inserted into your urethra, allowing your doctor to see inside your urethra and bladder. You will be given a local anesthetic before this test.

More Information

  • Computerized tomography (CT) urogram

  • Cystoscopy

  • Intravenous pyelogram

  • Prostate biopsy

  • PSA test

  • Urinalysis

Treatment Benign prostatic hyperplasia

If you have mild symptoms, you may only need to continue to observe your condition in order to make sure it doesn't get worse. There are a number of treatment options available if your symptoms are more severe.

A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. The best treatment choice for you depends on several factors, including:

  • The size of your prostate

  • Your age

  • Your overall health

  • The amount of discomfort or bother you are experiencing

If your symptoms are unit tolerable, you could possibly plan to delay treatment and easily monitor your symptoms. For a few men, symptoms will ease while not being treated.


Medication is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include:

  • Alpha blockers. These medications relax bladder neck muscles and muscle fibers within the prostate, creating evacuation easier. Alpha blockers — that embody alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax) and silodosin (Rapaflo) — typically work quickly in men with comparatively tiny prostates. Facet effects would possibly embody vertigo and a harmless condition within which seminal fluid goes back to the bladder rather than out the tip of the erectile organ (retrograde ejaculation). 

  • 5-alpha reductase inhibitors. These medications shrink your prostate by preventing secretion changes that cause prostate growth. These medications — that embrace finasteride (Proscar) and dutasteride (Avodart) — may take up to 6 months to be effective. aspect effects embrace retrograde ejaculation. 

  • Combination drug therapy. Your doctor might recommend taking an alpha blocker and a 5-alpha reductase inhibitor at the same time if either medication alone isn't effective.

  • Tadalafil (Cialis). Studies suggest this medication, which is often used to treat erectile dysfunction, can also treat prostate enlargement.

Minimally invasive or surgical therapy

Minimally invasive or surgical therapy might be recommended if:

  • Your symptoms are moderate to severe

  • Medication hasn't relieved your symptoms

  • You have a urinary tract obstruction, bladder stones, blood in your urine or kidney problems

  • You prefer definitive treatment

Minimally invasive or surgical therapy might not be an option if you have:

  • An untreated urinary tract infection

  • Urethral stricture disease

  • A history of prostate radiation therapy or urinary tract surgery

  • A neurological disorder, such as Parkinson's disease or multiple sclerosis

Any type of prostate procedure can cause side effects. Depending on the procedure you choose, complications might include:

  • Semen flowing backward into the bladder instead of out through the penis during ejaculation (retrograde ejaculation)

  • Temporary difficulty with urination

  • Urinary tract infection

  • Bleeding

  • Erectile dysfunction

  • Very rarely, loss of bladder control (incontinence)

There are several types of minimally invasive or surgical therapies.

Transurethral resection of the prostate (TURP)

A lighted scope is inserted into your canal, and also the MD removes near the outer part of the prostate. resection usually relieves symptoms quickly, and most men have a stronger piddle flow presently once the procedure. Once resection you would possibly quickly want a tube to empty your bladder.

Transurethral incision of the prostate (TUIP)

A lighted scope is inserted into your canal, and also the sawbones makes one or 2 little cuts within the ductless gland — creating it easier for excrement to tolerate the canal. This surgery could be an associate choice if you've got a tiny low or moderately enlarged ductless gland, particularly if you've got health issues that make different surgeries too risky.

Transurethral microwave thermotherapy (TUMT)

Your doctor inserts a special conductor through your duct into your prostate space. Microwave energy from the conductor destroys the inner portion of the enlarged prostate, shrinking it and easing weewee flow. TUMT may solely partly relieve your symptoms, and it would take it slow before you notice results. This surgery is mostly used solely on tiny prostates in special circumstances as a result of re-treatment could be necessary.

Transurethral needle ablation (TUNA)

In this procedure, a scope is passed into your channel, permitting your doctor to position needles into your endocrine gland. Radio waves taste the needles, heating and destroying excess prostate tissue that is obstructing water flow. TUNA could also be Associate in Nursing choice in choose cases, however the procedure isn't used to any extent further.

Laser therapy

A high-energy optical device destroys or removes overgrown prostate tissue. optical device medical aid typically relieves symptoms directly and features a lower risk of facet effects than will non laser surgery. optical device medical aid can be employed in men. The United Nations agency should not produce other prostate procedures as a result of them taking blood-thinning medications.

The options for optical device medical aid include:

  • Ablative procedures. These procedures vaporize clogging prostate tissue to extend piss flow. Examples embrace photoselective vaporization of the prostate (PVP) and atomic number 67 optical maser ablation of the prostate (HoLAP). Ablative procedures will cause irritating urinary symptoms when surgery, thus in rare cases another surgical process procedure could be required at some purpose. 

  • Enucleation procedures. Enucleation procedures, such as holmium laser enucleation of the prostate (HoLEP), generally remove all the prostate tissue blocking urine flow and prevent regrowth of tissue. The removed tissue can be examined for prostate cancer and other conditions. These procedures are similar to open prostatectomy.

Prostatic urethral lift (PUL)

Special tags are accustomed to compress the perimeters of the prostate to extend the flow of body waste. The procedure can be counseled if you've got lower tract symptoms. Afghan monetary unit additionally can be offered to some men involved regarding treatment impact on male erecticle dysfunction and ejaculatory issues, since the result on ejaculation and sexual operate is way lower with Afghan monetary unit that it's with TURP.


In this process, the blood provided to or from the prostate is by selection blocked, causing the prostate to decrease in size. Long information on the effectiveness of this procedure is not offered.

Open or robot-assisted prostatectomy

The operating surgeon makes AN incision in your lower abdomen to achieve the prostate and take away tissue. Open excision is mostly done if you've got an awfully giant prostate, bladder injury or different complicating factors. The surgery typically needs a brief hospital stay and is related to a better risk of needing an introduction.

Follow-up care

Your follow-up care can rely on the particular technique wont to treat your enlarged prostate.

Your doctor may suggest limiting work and excessive exercise for seven days if you've got optical maser ablation, transurethral needle ablation or transurethral microwave medical care. If you've got open or robot-assisted excision, you would possibly have to prohibit activity for 6 weeks. 

Treatment  Clinic

specialists have coaching in a very big selection of progressive technology to treat enlarged prostates. you've got access to the newest noninvasive optical device treatments, together with HoLEP and PVP lasers. Your salad dressing Clinic specialist can justify the variety of treatments accessible and assist you opt for the most effective approach supporting your symptoms.

Our caring team of salad dressing Clinic consultants will assist you along with your health issues. Visit salad dressing Clinic toilet facility Health to induce start.

Get the method started 

More Information

  • Benign prostatic hyperplasia (BPH) care at Mayo Clinic

  • Increased PSA levels

  • Ablation therapy

  • Holmium laser prostate surgery

  • Laser PVP surgery

  • Minimally invasive surgery

  • Prostate laser surgery

  • TUIP

  • TUMT

  • TURP

Lifestyle and home remedies

To help control the symptoms of an enlarged prostate, try to:

  • Limit beverages in the evening. Don't drink anything for an hour or two before bedtime to avoid middle-of-the-night trips to the toilet.

  • Limit caffeine and alcohol. They can increase urine production, irritate the bladder and worsen symptoms.

  • Limit decongestants or antihistamines. These drugs tighten the band of muscles around the urethra that control urine flow, making it harder to urinate.

  • Go when you first feel the urge. Waiting too long might overstretch the bladder muscle and cause damage.

  • Schedule bathroom visits. Try to urinate at regular times — like each four to 6 hours throughout the day — to "retrain" the bladder. This could be particularly helpful if you have got severe frequency and urgency. 

  • Follow a healthy diet. Obesity is associated with enlarged prostate.

  • Stay active. Inactivity contributes to urine retention. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.

  • Urinate — and then urinate again a few moments later. This practice is known as double voiding.

  • Keep warm. Colder temperatures can cause urine retention and increase the urgency to urinate.

Alternative medicine

The Food Associate in Nursing Drug Administration hasn't approved any flavoring medications for treatment of an enlarged prostate.

Studies on flavoring therapies as a treatment for enlarged prostate have had mixed results. One study found that Serenoa repens extract was as effective as finasteride in relieving symptoms of benign prostatic hyperplasia, though prostate volumes weren't reduced. However a resultant placebo-controlled trial found no proof that Serenoa repens is better than a placebo.

Other flavoring treatments — together with beta-sitosterol extracts, pygeum and rye grass — are instructed as useful for reducing enlarged prostate symptoms. however the protection and long-run effectualness of those treatments hasn't been proved .

If you're taking any flavoring remedies, tell your doctor. bound flavoring products may increase the danger of harm or interfere with different medications you take.

Preparing for your appointment

You might be referred directly to a doctor who specializes in urinary issues (urologist).

What you can do

  • Make a list of your symptoms,  

  • Keep track of how often and when you urinate, whether you feel you're completely emptying your bladder, and how much liquid you drink.

  • Make a list of your key medical information, including other conditions you might have.

  • Make a list of all medications, vitamins or supplements that you're currently taking.

  • Write down questions to ask your doctor.

Questions to ask your doctor

  • Is an enlarged prostate or something else likely causing my symptoms?

  • What kinds of tests do I need?

  • What are my treatment options?

  • How can I manage other health conditions along with an enlarged prostate?

  • Are there any restrictions on sexual activity?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is probably going to raise you a variety of queries. Being able to answer them may offer you longer to handle any considerations. you would possibly be asked:

  • When did you first begin experiencing urinary symptoms? Have they been continuous or occasional? Have they gradually worsened over time, or did they come on suddenly?

  • How often do you urinate during the day, and how often do you need to get up at night to urinate?

  • Have you ever leaked urine? Do you have a frequent or urgent need to urinate?

  • Is it difficult for you to begin urinating? Do you start and stop when urinating, or feel like you have to strain to urinate? Does it ever feel like you haven't completely emptied your bladder?

  • Is there any burning when you urinate, pain in your bladder area or blood in your urine? Have you had urinary tract infections?

  • Do you have a family history of enlarged prostate, prostate cancer or kidney stones?

  • Have you ever had any trouble getting and maintaining an erection (erectile dysfunction), or other sexual problems?

  • Have you ever had surgery or another procedure that involved insertion of an instrument through the tip of your penis into your urethra?

  • Are you taking any blood thinners, such as aspirin, warfarin (Coumadin, Jantoven) or clopidogrel (Plavix)?

  • How much caffeine do you consume? What is your fluid intake?

General summary

Treatment depends on the severity of symptoms and how quickly they progress In most cases you'll be given a number of treatment options rather than just one And it may take some trial-and-error testing to find which treatment works best for you Your doctor can help you decide what's best for your situation -- and also help keep track of your responses to treatments over time.

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