Benign Prostatic Hyperplasia (BPH)
What is BPH?
Benign Prostatic Hyperplasia, or BPH, is typically a non-cancerous enlargement of the prostate which leads to bothersome urinary symptoms over time. This prostate enlargement typically begins in a patient’s late 40s and can progress with age.
The diagnosis of BPH is made by a Urologist. If left untreated, BPH may progress and lead to infection, blood in the urine, stone formation in bladder, inability to urinate requiring a catheter, bladder weakening, or even kidney failure in rare cases.
What are the Symptoms?
Lower urinary tract symptoms (LUTS) are a consequence of an enlarging prostate over time. The rate of progression of symptoms typically varies. Common symptoms can include:
- Weak urinary flow
- Frequent or urgent need to urinate
- Waking up at night to urinate
- Difficulty starting urination
- Starting and stopping of urinary stream
- Feeling of incomplete emptying of bladder
- Dribbling after urination
What Causes BPH?
There are numerous risk factors for developing BPH over time. Some men will have a family history of the disease. Others may have medical co-morbidities such as obesity, diabetes, or heart disease that may play a role in BPH progression. Finally, normal aging and changes in sexual hormones are often involved.
How is BPH Diagnosed?
When you speak with one of our experienced Urologists in office, a comprehensive history and physical exam will be performed as well as a review of medications that could be worsening your urinary symptoms.
The following exams will help us with recommending a treatment:
- Urinalysis. this screens your urine for infection cells, microscopic blood, and glucose.
- Digital Rectal Exam. A finger inserted into the rectum is needed to rule out any cancerous nodules and to also estimate the size of the prostate gland.
- Urinary Symptom Score. This is a simple questionnaire that quantifies the severity of your symptoms and helps guide treatment.
- PSA. A PSA, or Prostatic Specific Antigen, is a blood test ordered to rule out prostate cancer.
- Voiding Flow Rate. A machine in the office will help measure the force of your stream and amount of urine voided. This can be used before and after treatments to gauge improvement.
- Post-Void Residual. A portable ultrasound can "scan" your bladder after you void to determine if you are not completely emptying due to prostate obstruction.
- Transrectal Ultrasound. An ultrasound done in office that can measure prostate volume and rule out any possibly cancerous lesions in the prostate.
- Cystoscopy. A small flexible telescope is inserted into the urethra to evaluate the degree of obstructed prostate, as well as the bladder. This procedure typically takes less than 2 minutes to perform.
How is BPH Treated?
There are multiple options to treat the disease, including behavioral modification, medications, minimally invasive in-office procedures, and surgery.