Enlarged Prostate (BPH)

What is the prostate?

From: MedlinePlus, National Library of Medicine

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

What is an enlarged prostate (BPH)?

From: MedlinePlus, National Library of Medicine

An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.

Usually, the prostate gland continues to grow during adult life. That's why BPH is the most common prostate condition in people over age 50. As the prostate gets bigger, it may press against the bladder and pinch the urethra. This can slow or block the flow of urine out of your bladder.

Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder cause many of the urinary problems you may have with BPH.

What causes an enlarged prostate (BPH)?

From: MedlinePlus, National Library of Medicine

Researchers aren't sure why the prostate keeps growing. Some researchers think changes in hormones with aging may cause the prostate to get bigger.

Who is more likely to develop BPH?

From: MedlinePlus, National Library of Medicine

You're more likely to develop BPH if you:

• Are age 40 or older. The chance of getting BPH increases as you get older.
• Have family members who have had BPH.
• Have certain health conditions such as: Obesity. Heart disease and problems with blood circulation. Type 2 diabetes. Erectile dysfunction.
• Don't get enough physical activity.

What are the symptoms of BPH?

From: MedlinePlus, National Library of Medicine

Symptoms of BPH include:

It's important to see your health care provider if you have any of these symptoms because they could be from a more serious health problem.

You should get medical help right away if you:

• Having a frequent or urgent need to urinate
• Waking up many times to urinate
• Having problems with urine flow, such as: Trouble starting to urinate A stream that's weak, slow, or stops and starts Dribbling after urination Urinary incontinence Feeling that you can't completely empty your bladder
• Pain after ejaculation or during urination
• Urine with an unusual color or smell
• Can't urinate at all
• Have fever and chills with urination that's painful, frequent, and urgent
• Have blood in your urine
• Have pain in your lower abdomen (belly) and urinary tract

What other problems can BPH cause?

From: MedlinePlus, National Library of Medicine

For most people, BPH doesn't cause other problems. But BPH increases your chance of developing serious conditions, including:

• Acute urinary retention. With this condition, you suddenly can't urinate at all. This a medical emergency. Acute urinary retention is common in older males and the chance of having it increases with age. It may be triggered by: Taking certain over-the-counter cold or allergy medicines Drinking alcohol Cold temperatures Not moving enough over a long period of time
• Urinary tract infections (UTIs)
• Bladder damage and bladder stones
• Kidney damage

How is BPH diagnosed?

From: MedlinePlus, National Library of Medicine

To find out if you have BPH, your provider will:

• Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
• Ask about your family health history.
• Examine you. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
• Order medical tests, if needed, such as: Urine tests. A PSA blood test (prostate-specific antigen test). Urodynamic testing to see how well you can hold and release urine. Cystoscopy to look inside your urethra and bladder. Ultrasound pictures of your prostate and urinary tract. A prostate biopsy to diagnose or rule out prostate cancer.

What are the treatments for BPH?

From: MedlinePlus, National Library of Medicine

Not everyone needs treatment for BPH. Treatment options depend on how much your symptoms bother you, your health, age, and the size of your prostate:

• Lifestyle changes may improve mild symptoms. They include: Drinking less before bedtime or going out Avoiding or cutting back on beverages with caffeine and alcohol Bladder training and exercising the muscles that control urine flow Preventing or treating constipation
• Medicines can help mild to moderate symptoms by: Stopping the prostate from growing Shrinking the prostate Relaxing muscles to improve urine flow Sometimes combining 2 types of medicine helps more than taking just one type of medicine.
• Medical procedures can help improve moderate to severe BPH symptoms when medicines don't help enough. There are several different types of procedures. They all use an instrument inserted into the urethra to either: Widen the urethra Destroy part of the prostate with heat
• Surgery may be helpful when symptoms are severe, other treatments haven't helped, or you have another problem, such as bladder damage. Different types of surgery are used to: Remove part or all of the prostate Make cuts in the prostate to take pressure off the urethra Most BPH surgery is done with tools inserted into the urethra.

Your provider can explain the possible benefits and side effects of your treatment options so you can decide what's best for you.

Can BPH be prevented?

From: MedlinePlus, National Library of Medicine

Researchers haven't found ways to prevent BPH. You can take care of your prostate health by:

• Talking with your provider about your risk for developing an enlarged prostate
• Getting regular checkups
• Paying attention to your symptoms so you can get treatment early if you see signs of BPH

Which doctor should you see?

The suggested department for discussing Enlarged Prostate (BPH) is Urology, with a urologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Which urinary or reproductive symptoms need further assessment?
• Could a blockage, structural problem or another cause be involved?
• What are the alternatives if a procedure is suggested?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.