Benign prostatic hyperplasia (BPH) is the abnormal growth of benign prostate cells. In BPH, the prostate grows larger and puts pressure on the urethra and bladder, blocking the normal flow of urine. This causes the flow of urine to weaken, the need to get up in the night to urinate more often, and eventually even the inability to go. More than one-half the men in the United States between the ages of 60 and 70 and as many as 90% between the ages of 70 and 90 have some urinary symptoms resulting from an enlarged prostate.
A good measure of the seriousness of benign prostatic hyperplasia (BPH) -- enlarged prostate -- is the severity, or frequency, of your symptoms. BPH is not a life-threatening condition and will not lead to worse disease such as prostate cancer. But if urinary symptoms worsen, BPH can become extremely bothersome and cause anxiety and worry.
Some evidence suggests that the more severe symptoms of BPH are associated with an increased risk of developing a serious condition called acute urinary retention (which is the inability to urinate despite a strong urge to do so). Episodes of acute urinary retention are very unusual. But if it does occur, you should treat it like an emergency and get immediate medical attention.
BPH can also become more serious if bladder function deteriorates. If the bladder becomes more sensitive to the urine that is left in it after urinating, incontinence can occur. Fortunately, incontinence also is unusual.
For the vast majority of men, BPH is nothing more than an annoyance.
More than one-half of men over the age of 70 have symptomatic benign prostatic hyperplasia (BPH), or enlarged prostate, and nearly 90% of men have microscopic evidence of an enlarged prostate. Moderate to severe symptoms also become more common with increasing age: 17% of patients in their 50s suffer from moderate to severe symptoms, while 27% experience such symptoms in their 60s and 37% in their 70s.
Assuming that no urinary tract complications (such as bladder stones or acute urinary retention) that need to be treated exist, the course of benign prostatic hyperplasia (BPH) -- enlarged prostate -- is very difficult to predict. Every man is different, and the response to having no treatment may vary from man to man. The severity, or frequency, of a man's symptoms might help predict the outcome, though. Some men with mild, or infrequent, symptoms actually get better, but most stay about the same or gradually get a little worse.
Men who experience severe, or very frequent, symptoms are less likely to see improvement in their condition without treatment; but the symptoms may not get much worse either. Still the chance that men with severe symptoms will need treatment later on is greater. A progressive decrease in the size and force of urinary stream and the feeling that the bladder has not completely emptied after urinating are two symptoms that seem to be most closely related to the eventual need for treatment. If treatment is needed, there is a full range of options -- some with very low risk. Remember, when BPH-related problems become overly bothersome to you, it is appropriate to seek treatment.
Call your doctor immediately if:
- You are completely unable to urinate.
- Urination is painful and you have a fever over 100°F (37.8°C), chills or body aches.
- You have pain in the lower back, just below your rib cage ( flank pain ), that is not related to an injury or physical effort.
- There is blood or pus in your urine or semen.
Call your doctor if you have painful urination and any of the following signs of a possible urinary tract infection or prostate infection that last longer than 24 hours:
- A burning sensation while urinating
- Painful ejaculation
- Problems controlling your urination during the day or at night
Call your doctor if you have urination problems that have developed over a few weeks or a few months and are frequent.
Watchful waiting If urinary symptoms are minor or they don't bother you too much, and you do not have prostate cancer or a prostate infection, it may be appropriate to try watchful waiting or home treatment. Call a doctor if your symptoms change or get worse or if you change your mind about treatment.
Who to see Mild and moderate urinary symptoms that are caused by BPH can be evaluated and treated by any of the following health professionals:
- Nurse practitioner
- Physician assistant
- Family medicine doctor
If the symptoms are severe or if surgical treatment is being considered, you probably need to see a urologist.
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1 AnswerMarc Garnick, Oncology, answeredBenign prostatic hyperplasia (BPH), or enlarged prostate, can produce complications that, while not life-threatening, nonetheless require medical attention. If the blockage is so severe that it keeps your bladder from emptying completely, you may be vulnerable to frequent urinary tract infections. The risk of developing bladder stones also increases. The growth of the prostate can rupture blood vessels in the urethra, causing blood to appear in the urine.
If obstructive BPH goes untreated for too long, the bladder may become distended, its muscular wall may weaken, and you may be unable to squeeze any urine past the obstructing prostate gland, a condition known as acute urinary retention. The bladder may become so distended that urine cannot adequately empty from the kidneys. In the most severe cases, this can lead to kidney failure.
And not being able to urinate at all is a medical emergency, requiring the temporary passage of a catheter (a thin tube) through the urethra to allow the bladder to drain. Fortunately, such complications are uncommon because most men seek medical attention well before serious problems develop.
1 AnswerMarc Garnick, Oncology, answeredEvidence suggesting a link between prostate enlargement and Western dietary patterns has emerged. Researchers for the 51,529-participant Health Professionals Follow-up Study reported that men with a higher intake of calories, protein, and some specific forms of polyunsaturated fats were more likely to develop an enlarged prostate than those who ate less.
An analysis of the same participants showed that those who consumed the fewest vegetables had the highest risk of developing an enlarged prostate. A study of 4,770 participants in the Prostate Cancer Prevention Trial came to some similar conclusions: risk rose with a diet low in vegetables and high in total fat, polyunsaturated fat, and red meat. However, this study came to the opposite conclusion about protein, finding that it might actually reduce risk.
Men who are older than 50 have a higher risk for benign prostatic hyperplasia (BPH).
The hormone testosterone, which is produced mainly by the testicles, is needed in order for BPH to develop. Men who have their testicles removed before puberty never develop BPH. Men who have their testicles removed after puberty (but before they have symptoms of BPH) rarely develop BPH.
A family history of BPH may increase your risk for needing treatment for this condition, especially if a relative needed treatment before age 60.
A vasectomy does not increase your risk of BPH.
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The prostate gland grows as men age, with the fastest growth occurring at middle age. By age 50, 5 out of 10 men have an enlarged prostate. By age 80, up to 9 out of 10 men have an enlarged prostate. Having an enlarged prostate does not always cause symptoms.
As the prostate enlarges, the urethra (the tube that carries urine from the bladder out of the body) may become narrowed or partially blocked. The narrowed or blocked urethra is what causes the symptoms of benign prostatic hyperplasia (BPH). By age 55, over 2 out of 10 men have some symptoms. By age 75, 5 out of 10 men complain of a decrease in the force of their urine streams.
In rare cases, severe obstruction of the urine flow occurs and may lead to complications, including complete or partial blockage of the urethra, urinary tract infection (UTI), bladder stones, or visible blood in the urine.
Every man's experience with BPH is different. Symptoms may be stable, may come and go or may become more bothersome over time. Some men find the symptoms to be mild and do not require treatment with medicines. Other men find the symptoms bothersome and choose treatment with medicine or, less commonly, surgery.
BPH does not cause prostate cancer. But prostate cancer may cause symptoms similar to those of BPH. It is important to have your symptoms checked by a doctor to be certain they are not caused by prostate cancer.
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Benign prostatic hyperplasia (BPH) is probably a normal part of the aging process in men. It is caused by changes in hormone balance and cell-growth factors. Genetics may also play a role. This is especially true for severe BPH requiring surgery in men younger than 60.
Men who are older than 50 have a higher chance of developing BPH. But why some men have more severe symptoms than others is not known.
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