Urinary Incontinence
What is BPH (Benign Prostatic Hyperplasia)?
Benign Prostatic Hyperplasia, commonly known as BPH or enlarged prostate, is a non-cancerous condition where the prostate gland grows larger than normal. This common condition affects millions of men, particularly as they age, and can significantly impact urinary function and quality of life.
The term “benign” means the condition is not cancerous, “prostatic” refers to the prostate gland, and “hyperplasia” means abnormal cell growth. While BPH is not prostate cancer and doesn’t increase cancer risk, it can cause bothersome urinary symptoms that interfere with daily activities.
50% of men in their 50s experience BPH symptoms
70% of men in their 60s are affected by BPH
90% of men over 80 have some degree of prostate enlargement
Understanding the Prostate Gland and BPH
The prostate is a small, walnut-sized gland that sits below the bladder and surrounds the urethra, the tube that carries urine from the bladder out of the body. The prostate produces fluid that nourishes and transports sperm, making it an essential part of the male reproductive system.
As men age, the prostate naturally continues to grow. In BPH, this growth becomes excessive, causing the gland to press against the urethra and bladder. This pressure restricts urine flow and can prevent the bladder from emptying completely, leading to various urinary symptoms.
Important Distinction
BPH is not prostate cancer and does not increase your risk of developing prostate cancer. However, both conditions can occur simultaneously, which is why regular prostate screenings are important for men over 50.
Common BPH Symptoms
BPH symptoms develop gradually and can range from mild annoyances to serious complications. The severity of symptoms doesn’t always correlate with the size of the prostate enlargement. Some men with significantly enlarged prostates experience minimal symptoms, while others with moderate enlargement have severe problems.
Urinary Frequency
Needing to urinate more often than usual, especially at night (nocturia). Many men with BPH wake up multiple times during the night to use the bathroom, disrupting sleep quality.
Urgency
Sudden, strong urge to urinate that’s difficult to postpone. This urgent feeling can occur frequently and may lead to occasional incontinence if a bathroom isn’t immediately accessible.
Weak Stream
Reduced force and flow of the urine stream. Starting urination may take longer than normal, and the stream may be weaker or interrupted, sometimes stopping and starting during urination.
Difficulty Starting
Hesitancy or trouble initiating urination. You may need to wait or strain before urine flow begins, even when the bladder feels full.
Incomplete Emptying
Feeling that the bladder hasn’t fully emptied after urination. This sensation often leads to returning to the bathroom shortly after, as residual urine remains in the bladder.
Dribbling
Post-void dribbling or leaking of urine after you’ve finished urinating. This occurs because urine remains trapped in the urethra due to prostate pressure.
What Causes BPH?
The exact cause of BPH isn’t fully understood, but researchers believe several factors contribute to prostate enlargement. Hormonal changes that occur with aging appear to play a significant role in the development of BPH.
As men age, the balance of sex hormones changes. Testosterone levels decrease while the proportion of estrogen increases. Additionally, dihydrotestosterone (DHT), a more potent form of testosterone that accumulates in the prostate, may promote prostate cell growth. These hormonal shifts may trigger the excessive cell multiplication characteristic of BPH.
When to Seek Medical Help
Don’t wait until symptoms become severe to consult a healthcare provider. Early intervention leads to better outcomes and can prevent complications. You should seek medical attention if you experience any of the following: inability to urinate at all, painful or burning urination, blood in urine, frequent urinary tract infections, symptoms that significantly impact your quality of life, or waking up more than twice nightly to urinate.
The Importance of Early Treatment
Many men delay seeking treatment for BPH due to embarrassment or assuming symptoms are a normal part of aging. However, BPH is a treatable medical condition, not an inevitable consequence of getting older. Early diagnosis and treatment can prevent complications, preserve bladder and kidney function, and significantly improve quality of life.
