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Benign Prostate Hyperplasia (BPH)

Overview

The prostate is a gland that is found only in men. Its purpose is to secrete the major component of ejaculatory fluid. The prostate, which continues to grow throughout life, sits directly below the bladder and surrounds the urethra as it exists the bladder.

As a man ages, the prostate enlarges and begins to press on and narrow the opening of the bladder neck and urethra. This occurs gradually over several years. Initially symptoms may be extremely subtle and well tolerated such as urinating frequently, decrease force of urinary stream, and urinating more than twice at night. As the condition progresses the bladder has to work harder to expel urine. This causes the bladder muscle to become thick (hypertrophic). This results in a diminished bladder capacity and decreased elasticity of the bladder wall, causing problems with urinary function

Normal Prostate image  Enlarged Prostate image

The symptoms which were tolerable previously advance to greater frequency (more than every 2 hours, difficulty initiating a stream, urgency to urinate, incontinence, retention of urine and complete inability to void the bladder). In medicine, doctors refer to these symptoms as Lower Urinary Tract Symptoms (LUTS). The common, non-cancerous condition of enlargement of the prostate is called benign prostate hyperplasia or BPH.

This condition affects about 40% of men in their 50's, 60% of men in their 60's and more than 80% of men in their 80's. About half of such men develop moderate to severe Low Urinary Tract Symptoms (LUTS), which could interfere with advancing age.

When the prostate initially begins to enlarge, the bladder muscle can usually push urine through the constricted urethra. As the narrowing continues, the bladder muscle could become thicker or weaken. This would increase urgency to urinate or strain to empty the bladder. 

Men with LUTS and BPH also have been found to be at greater risk for Erectile Dysfunction (ED). The connection between LUTS, BPH and ED is not entirely clear. If you are experiencing LUTS or ED, please contact your health care provider.

If left untreated, an enlarged prostate can cause permanent urinary problems. While it may be a natural part of the aging process, that doesn't mean you have to live with it. There are effective options for treatment


BPH Symptom Score Index - How severe are your enlarged prostate symptoms?

In assessing your symptoms our office uses the BPH symptom score index also known as the American Urological Association Score. The purpose of the test is to determine how bothersome the enlargement of the prostate is. 

Question Not at all Less than
1 time in 5
Less than
half the time
About half
the time
More than
half the time
Almost
always
Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?
Over the past month, how often have you had to urinate again less than 2 hours after you finished urinating?
Over the past month, how often have you found you stopped and started again several times when you urinated?
Over the past month, how often have you found it difficult to postpone urination?
Over the past month, how often have you had a weak urinary stream?
Over the past month, how often have you had to push or strain to begin urination?
Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?

Calculate your BPH Score

Prostate health can affect your lifestyle

Many men affected by an enlarged prostate report lifestyle changes such as avoiding travel, interrupted leisure activities, and embarrassment about using urinals. Frequent nighttime trips to the bathroom can disrupt sleep for both enlarged prostate sufferers and their partners as well.


Symptoms

If you have an enlarged prostate, you may experience these symptoms:

  • A frequent urge to urinate, especially at night

  • An urgent need to urinate with little warning

  • Difficulty beginning urination

  • Pain or burning during urination

  • Feeling that your bladder never completely empties

  • Dribbling or leaking urine

  • A weak urine stream

  • Intermittent—or on/off—urine flow

  • Blood in the urine 


How is an enlarged prostate (BPH) diagnosed?

Whether you first notice difficulty with urination or your doctor finds that your prostate is enlarged during a routine exam, a smart first step toward a solution is an appointment with our office—that specializes in urinary tract and male reproductive system health. Several tests help identify the problem and suggest the best course of action. Tests vary from patient to patient, but these are the most common:

  • Digital Rectal Exam (DRE)

  • Prostate Specific Antigen (PSA) Blood Test

  • Rectal Ultrasound

  • Urine Flow Study


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