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Benign Prostatic Hyperplasia - The Symptoms, Treatment & Management

Summary

Benign prostatic hyperplasia (BPH), is a non-cancerous enlargement or benign increase in the size of the prostate gland in men. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partially block the urethra. This often causes problems with urinating. Troublesome urinary symptoms are sometimes, but not always, symptoms of prostate cancer and should be investigated thoroughly. However, BPH occurs in almost all men as they age and although it is not a serious problem, about half of all men older than 70 have some symptoms that require treatment.

Symptoms of BPH

Many men experience urinary symptoms as they age and some may become noticeable enough that they warrant treatment. However, an enlarged prostate doesn’t always cause urinary problems. Studies indicate that the size of a man’s prostate gland has little influence on the type or severity of his urination problems. BPH is just one possible cause of urinary symptoms. Urinary symptoms commonly experienced with prostate problems include:

  • the need to urinate frequently during the night
  • urinating more often during the day
  • urinary urgency – the urge to urinate can be so strong and sudden that you may not reach the toilet in time
  • the urine stream is slow to start
  • urine dribbling for some time after finishing urination
  • a sensation that the bladder isn’t fully emptied after urination
  • lack of force to the urine flow, which makes directing the stream difficult
  • the sensation of needing to go again soon after urinating.

In a small number of cases, BPH may cause the bladder to be blocked, making it impossible or extremely hard to urinate. This problem may cause backed-up urine (urinary retention), leading to bladder infections or stones, or kidney damage and requires urgent medical attention. Pain with urination or blood in the urine are also symptoms to be followed up with your regular doctor immediately if you are experiencing.

Treatment and management

As a rule, you don't need treatment for BPH unless the symptoms bother you sufficiently or you have other problems such as backed-up urine, bladder infections, or bladder stones. If your symptoms are severe your doctor may suggest surgery to remove part of your prostate, although very few men have symptoms or other problems significant enough to need surgery. Your doctor may also suggest various medications to help ease your urinary problems, including:

  • medications to reduce the tone of the muscles of the urethra and prostate to minimise any constriction to urine flow caused when these muscles contract
  • medications to reduce the size of the prostate gland. These drugs work by blocking the action of male hormones produced by the prostate gland
  • medications to relax the bladder, making unwanted contractions less likely and reducing the symptoms of urgency and frequency of urination

If your urination problems are simple and don’t bother you very much, steps you can take at home include:

  • minimise drinks such as coffee, caffeinated soft drinks and alcohol, especially before bedtime, if getting up at night to pass urine is disturbing your sleep
  • learn pelvic floor and bladder retraining exercises as they may help to ease some urinary symptoms
  • practice "double voiding" Urinate as much as you can, relax for a few moments, and then urinate again
  • avoid medicines that can make urination difficult, such as over-the-counter antihistamines, decongestants and opiates. Check with your doctor or pharmacist about the medicines you take.