Benign Prostatic Hyperplasia

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An Enlarged Prostate Is Common, Treatable

As a man ages, his prostate typically grows. This growth can restrict the tissue surrounding it, causing a number of issues, including a gradual loss of bladder function. We can help.

Overview

What is Benign Prostatic Hyperplasia?

Benign prostatic hyperplasia (BPH) is a common condition as men age. It involves benign (non-cancerous) enlargement of the prostate. For many men, as they reach their 40s or 50s, the prostate can grow, leading to blockage of the urethra and more difficulty with urination. It can block the flow of urine leading to lower urinary tract symptoms, also known as LUTS.

Watch this in-depth presentation about BPH and how it's treated.

Symptoms

What are the symptoms of Benign Prostatic Hyperplasia?

You may experience one, some, or all of the following symptoms:

Difficulty starting your urinary stream
Incomplete emptying of the bladder
Straining to urinate
Sudden urge to urinate
Urinary frequency
Urinary leakage
Waking up at night to urinate.
Weaker stream

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Cause

What causes Benign Prostatic Hyperplasia?

As you age, your prostate can enlarge, often beginning around the age of 40-50. BPH is a benign (non-cancerous) condition that is very common in males. However, this enlargement tends to block the urethra and urine flow out of the body. Urinary symptoms, although commonly related to an enlarged prostate in men, can also be due to urinary tract infections, bladder or kidney stones, urethral stricture/scar tissue formation, inflammation of the prostate (prostatitis), problem with the nerves to the bladder, or a cancer of the bladder or prostate, so it’s important to see your urologist if you experience these symptoms.

Diagnosis

How is Benign Prostatic Hyperplasia diagnosed?

What to know before your visit to MidLantic Urology in Philadelphia and surrounding counties:

During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with focused attention to the abdomen and genitalia. The physician may have you fill out a short survey with questions regarding how you urinate.

Tests that may be performed during or after your visit:

Digital rectal exam: The physician inserts a finger into your rectum to check for the size of your prostate and to evaluate for any abnormalities.
Urinalysis: A urine test to evaluate for any blood in the urine or infection.
Blood test: A blood test called a PSA (prostate-specific antigen) test is often completed to help determine your risk for prostate cancer.
Post-void residual: The physician will often ask you to urinate and then check to make sure you are emptying your bladder.
Urine flow: The physician may have you urinate in a funnel to assess the speed of your urinary stream.
Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the penis to assess the urethra for any scar tissue and evaluate the prostate for any evidence of obstruction.
Prostate ultrasound: A probe is inserted into the rectum to check the size and shape of the prostate.
Urodynamics: This is a test where a small tube is inserted into the penis and another into the rectum to help measure the pressures in the bladder during urination.
Urocuff test: An easy, in-office test to measure urine flow with the use of a small cuff around the penis.

Treatment

How is Benign Prostatic Hyperplasia treated?

NON-SURGICAL TREATMENT

Lifestyle modifications: We often believe the most conservative course of action is best to try first, unless circumstances warrant a more aggressive approach. There are some simple steps you can take without medications or procedures that can improve your BPH-related urinary symptoms, including changing bathroom habits and dietary changes.
Alpha blockers: Relaxes the prostatic urethra and bladder neck, making urination less difficult.
- Most common medications include tamsulosin (Flomax), silodosin (Rapaflo), and alfuzosin (Uroxatral)
5-alpha reductase inhibitors: Shrinks the prostate (takes 4-6 months to start working)
- Most common medications include finasteride (Proscar) and Dutasteride (Avodart)
Tadalafil (Cialis): Improves quality of life related to urination and also is used to treat erectile dysfunction

SURGICAL TREATMENT

Prostatic Urethral Lift (UroLift®): A minimally invasive procedure involving implantation of suture material to move the prostate away from the urethra and correct the obstruction. Click here to learn more about UroLift®.
Water Vapor Therapy (Rezum®): An in-office minimally invasive procedure involving the use of water vapor therapy to shrink the prostate and correct the obstruction.
Laser Prostatectomy: This involves a scope in the urethra (tip of penis) with laser vaporization of prostatic tissue
Transurethral resection of prostate (TURP): This involves a scope in the urethra (tip of penis) with resection and removal of prostatic tissue
HOLEP: This involves a scope in the urethra (tip of penis) with enucleation and removal of prostatic tissue
Robotic or open simple prostatectomy: This involves surgical removal of the obstructing part of the prostate either through a small incision or via robotic-assisted laparoscopy
Aquablation: A heat-free waterjet controlled by robotic technology is used to remove prostate tissue. No incision is made, as the prostate is reached through the urethra. It can be performed on prostates of any size and shape.