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UrologicalICD-10: N40.0Affects over 50% of men over 60 and up to 90% of men over 85

Benign Prostatic Hyperplasia (BPH)

Also known as: Enlarged Prostate, BPH, Prostate Enlargement, Benign Prostate Hypertrophy

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that commonly affects men as they age, causing the prostate to press against the urethra and obstruct urine flow. Symptoms typically include frequent urination, difficulty starting urination, and a weak urine stream, which can significantly impact quality of life and sleep. While BPH is not prostate cancer and does not increase cancer risk, it can lead to complications such as urinary tract infections, bladder stones, and kidney damage if left untreated.

Symptoms

Frequent urination, especially at night (nocturia)
Difficulty starting urination or weak urine stream
Urgent need to urinate
Inability to completely empty the bladder
Dribbling at the end of urination
Straining while urinating
Urinary incontinence in advanced cases

Causes

  • Age-related hormonal changes, particularly increased dihydrotestosterone (DHT)
  • Imbalance between cell growth and programmed cell death in the prostate
  • Changes in estrogen and testosterone ratios with aging
  • Growth factor signaling stimulating prostate cell proliferation

Risk Factors

  • Age over 50 (affects over 50% of men in their 60s)
  • Family history of BPH or prostate conditions
  • Obesity and metabolic syndrome
  • Lack of physical activity
  • Diabetes and heart disease
  • Ethnicity (higher prevalence in Black men)

Diagnosis

  • Digital rectal examination (DRE) to assess prostate size and texture
  • Prostate-specific antigen (PSA) blood test to rule out prostate cancer
  • Urinalysis to check for infection or blood in the urine
  • Uroflowmetry to measure the rate and volume of urine flow
  • Post-void residual volume measurement via ultrasound

Treatment

  • Alpha-blockers (tamsulosin, alfuzosin) to relax prostate and bladder neck muscles
  • 5-alpha-reductase inhibitors (finasteride, dutasteride) to shrink the prostate
  • Combination therapy with alpha-blockers and 5-alpha-reductase inhibitors
  • Minimally invasive procedures such as UroLift or Rezum water vapor therapy
  • Transurethral resection of the prostate (TURP) for severe obstruction
  • Lifestyle modifications including reduced caffeine and alcohol intake

Prevention

  • Maintain a healthy weight through regular exercise
  • Eat a diet rich in fruits, vegetables, and healthy fats
  • Limit caffeine and alcohol consumption, especially in the evening
  • Stay physically active with at least 30 minutes of exercise daily
  • Have regular prostate screenings after age 50

When to See a Doctor

  • Urinary symptoms interfere with daily activities or sleep
  • You are unable to urinate or experience complete urinary retention
  • You notice blood in your urine or experience pain during urination
  • Symptoms progressively worsen despite conservative management

Frequently Asked Questions

Related Conditions

Type 2 Diabetes

Endocrine

Obesity

Metabolic

High Blood Pressure

Cardiovascular

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