Men, If You’re Over 50, You Probably Have BPH. What Is It?

Let’s face it, fellas. As the sand in the hourglass continues to trickle out, we’re going to face a crop of health issues as we get older.

But we have resources to help us live our best lives as we welcome age-related issues, such as benign prostatic hyperplasia (BPH), which medically describes a condition that’s the number one reason we visit the urologist after turning 50: an enlarged prostate. It’s so common one in two men over 50 will develop the condition.

But what is BPH, exactly? And what’s it mean for you?

Dr. John Lee, a board-certified urologist with Lee Health Urology, walks us through BPH, leaving no (kidney) stone unturned.

Q: What is benign prostatic hyperplasia?

BPH generally describes an enlarged prostate gland in men, which tends to get bigger as men age. The enlarged prostate can press on the urethra, narrowing it and thus obstructing the ability of the bladder to pass urine or fully empty.

Research shows that the condition occurs in about half of all men between the ages of 51 and 60. After age 70, 80 to 90 percent of men develop BPH. It’s very common.

Q: What causes BPH, and what are its symptoms?

We don’t know exactly what causes BPH, but if left untreated, it can worsen with symptoms that can reduce your quality of life. Symptoms of benign prostatic hyperplasia may include:

• urinary frequency—urination eight or more times a day
• urinary urgency—the inability to delay urination
• trouble starting a urine stream
• a weak or an interrupted urine stream
• dribbling at the end of urination
• nocturia—frequent urination during periods of sleep
• urinary retention
• urinary incontinence—the accidental loss of urine
• pain after ejaculation or during urination
• urine that has an unusual color or smell

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Q: Are there factors that make some men more likely to develop BPH than others?

If you’re 40 years and older, that’s a risk. Other factors that make it more likely a man can develop symptoms of BPH include a family history of BPH, having medical conditions such as obesity, heart and circulatory disease, and type 2 diabetes. Lack of physical exercise and erectile dysfunction are other factors as well.

Q: You mentioned that if left untreated, in some cases BPH can get worse. What are the complications?

In some men, BPH may not cause any problems. BPH means that the prostate is getting larger. Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms.

Less than half of all men with benign prostatic hyperplasia show symptoms. In some men with BPH symptoms, an enlarged prostate left untreated may lead to worse symptoms such as urinary tract infections, urinary incontinence, blood in the urine, development of bladder stones, kidney failure, and finally, the inability to urinate. Over time, as a prostate gets larger and the symptoms worsen, it’s important to seek help from a urologist.

Most men with BPH don’t develop the following complications, but they do occur and may include:

• Acute urinary retention
• Chronic or long-lasting urinary retention
• Blood in the urine
• Urinary tract infections (UTIs)
• Bladder damage
• Kidney damage
• Bladder stones

Source: NIDDK

Q: When should I seek medical care for BPH?

Men with symptoms of benign prostatic hyperplasia should see their doctor. Sometimes, urinary symptoms are unrelated to BPH but are instead caused by bladder problems, UTIs, or prostatitis—inflammation of the prostate.

If you have any of the following symptoms, you should seek immediate medical care:

• Complete inability to urinate
• Painful, frequent, and urgent need to urinate, with fever and chills
• Blood in the urine

Q: How is BPH treated?

Treatment options for benign prostatic hyperplasia may include:

• Lifestyle changes.
  • Practice meditation or yoga to reduce tension and stress, which can aggravate BPH symptoms.
  • Choose healthier food options to keep your prostate healthy.
  • Avoid beverages that stimulate the kidneys to produce urine, such as caffeinated and alcoholic drinks.
• Medications.
  • Your urologist may prescribe medications that help open the prostate channel or shrink the prostate or reduce symptoms associated with BPH.
  • Certain medications may increase your BPH symptoms. Consult with your doctor to see if any medications you’re taking are impacting your BPH.
• Minimally invasive procedures. When medications or lifestyle changes prove ineffective in reducing the symptoms of BPH, surgical options may include:
  • transurethral needle ablation
  • water-induced thermotherapy
  • prostatic urethral lift
• Surgery. Urologists typically recommend surgery when medications and minimally invasive procedures are ineffective, your symptoms are severe and impact your quality of life, or to avoid immediate complications.

For long-term treatment of BPH, your urologist may recommend widening the urethra to improve flow by removing enlarged prostate tissue. Although removing troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue removal doesn’t cure BPH.

Surgery to remove enlarged prostate tissue includes:

• transurethral resection of the prostate (TURP)
• laser vaporization of the prostate
• laser enucleation of the prostate
• robotic or open simple prostatectomy
• transurethral incision of the prostate (TUIP)
• robotic waterjet ablation of prostate

READ: Aquablation therapy. This new, advanced treatment is changing lives for men with BPH. 

Your urologist will treat your BPH based on the severity of your symptoms, how much the symptoms impact your daily life, and your preferences.

Many men don’t need treatment for a mildly enlarged prostate unless their symptoms become bothersome and affect their quality of life. In these cases, instead of treatment, your doctor may recommend regular checkups to monitor your condition. If your symptoms worsen or present a health risk, your urologist will recommend treatment.

Lee Physician Group's highly trained and compassionate urologists set the standard for care. We lead the way in new technology, treatment options, and making connections with our patients all over Southwest Florida.

For a consultation or to schedule an appointment with a urology expert, call Lee Health Urology at 239-343-3429.