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What is Benign Prostatic Hyperplasia?
Benign Prostatic Hyperplasia (BPH) is a condition where the prostate gland grows in size, which can obstruct the flow of urine and sperm passing through your urethra. BPH is the most common growth found in men, and it is noncancerous, or “benign.” While the enlargement may be of little concern, the symptoms you experience can be uncomfortable or difficult to manage, and negatively affect a person’s quality of life.
In its normal state, the prostate is a walnut-sized gland located below your bladder, surrounding part of the urethra. The urethra is the tube that empties the urine from the bladder. When the prostate grows in size, it can squeeze against the urethra, limiting or even stopping the flow of urine. This can lead to difficulty or increased need for urination during the day and/or night, and discomfort. BPH is the most common prostate problem for men between the ages of 45-90+.
Symptoms of Benign Prostatic Hyperplasia
Benign Prostatic Hyperplasia can lead to a variety of urinary symptoms, as well as bladder, urinary tract infections, or kidney problems. The severity of symptoms in people with an enlarged prostate gland varies, but they tend to worsen gradually over time and can become very uncomfortable.
Common Symptoms
- Bladder Pressure (causing the sensation of needing to urinate)
- Frequent Urination (day and/or night)
- Weak Urine Stream/Straining to Urinate
- Urinary Retention
- Frequent Night Urination
- Urinary Urgency
- Intermittent Urination (urine stream starts/stops while trying to urinate)
Risk Factors of Benign Prostatic Hyperplasia
BPH affects men as they age. Prostate gland enlargement symptoms are rarely evident in men younger than age 40. Approximately 50% of men by age 50 have BPH, which increases to 70% of men by age 70, and about 80% of men over 80. Many men have none of these risk factors, and can still have an enlarged prostate, as it is associated with the normal aging process in men. While some men may have little to no symptoms, others may have bothersome symptoms that unnecessarily affect their good quality of life and be more at risk. Risk factors for men include:
BPH Risk Factors
- Men over 50
- Diabetes
- Heart Disease
- Obesity
- Family History
- Diet high in meat and dairy
Enlarged Prostate Causes
Enlargement of the prostate is a normal process as men age. The actual cause of an enlarged prostate is unknown, but it is widely speculated that hormonal changes may be the cause. There are studies that show a connection between enlarged prostate glands and dihydrotestosterone (DHT) levels in the blood. High levels of estrogen have also been linked to enlarged prostates. As men get older and produce less testosterone in their blood, it creates a larger portion of estrogen. The research on the causes of BPH is ongoing.
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Benign Prostatic Hyperplasia Diagnosis
If you are experiencing symptoms of BPH, your doctor will perform a physical exam and ask detailed questions about your symptoms. Medical history should include questions about over-the-counter and prescription medications being taken. A thorough diagnosis has to be developed before proceeding with any action or seeing a prostate specialist.
BPH Diagnostic Tests & Exams
- Checking the lower abdomen for a mass
- Digital rectal exam (DRE)
- Urinalysis/Urine culture
- Blood Urea Nitrogen (BUN) Test
- Prostate Specific Antigen (PSA) Test
Prostate Artery Embolization
Prostate Artery Embolization, or PAE, is a safe and effective treatment option for men with BPH. Using a small catheter, tiny particles are injected into the arteries supplying blood to the prostate. By decreasing the blood flow to the prostate, it shrinks. Like other minimally invasive procedures, it offers several advantages over traditional surgery. The good news is, it is performed as an outpatient procedure, requiring no hospital stay and providing a shorter recovery time. You will experience virtually no blood loss with minimal pain or discomfort. There is a much lower risk compared to traditional procedures, with less than 1% major complication risk and virtually no sexual side effects or risk of incontinence. Results can be experienced within a few days.
PAE vs TURP
TURP, or transurethral resection of the prostate is another type of prostate surgery. Although TURP may be considered minimally invasive, it is still a form of surgery. A resectoscope is inserted into the tip of the penis, through the urethra, and the doctor removes the tissue. You can experience heavy bleeding, infection, erectile dysfunction, incontinence, and difficulty urinating. You will usually need a catheter in the penis and bladder for a number of weeks or more after the procedure, while you are recovering. PAE is less invasive and lowers the risk of complications.
PAE vs UroLift
Another alternative to PAE is a procedure called UroLift, where a doctor inserts very small implants in the urethra, to lift and hold the prostate out of the way, so it no longer blocks the flow of urine. However, this procedure is only available for men with smaller prostate glands and is not recommended if you have a large prostate volume, or a urinary tract infection. With PAE, there is no limit on the prostate size for treatment.
What to Expect from Your Prostate Artery Embolization
Benign Prostatic Hyperplasia FAQ
The prostate gland has several roles. Its main role is to produce seminal fluid, to nourish and lubricate the urethra. This allows for the natural and easy transport of urine and sperm out of the penis. This fluid is a component of semen. The prostate gland is located below the bladder and surrounds the urethra. The urethra is the tube in which urine flows from the bladder. When the prostate becomes enlarged, it can obstruct the flow of urine and result in painful and uncomfortable symptoms.
An enlarged prostate isn’t always serious. A prostate is usually enlarged for one of two reasons. The most common reason is Benign Prostatic Hyperplasia (BPH) which happens normally as men age. Although much less common, a second cause of prostate enlargement can be cancer. Prostate health is important for men and any changes in urination should always start with a visit to a urologist to ensure the body’s health and safety. When diagnosed with BPH, a non-cancerous enlarged prostate, you should schedule a proper follow-up with a prostate specialist. It is only as serious as the symptoms you’re bothered by. Our prostate specialists can offer you treatment without surgery.
If BPH is left untreated, complications can arise. The obstructed urethra can cause an irritable bladder, which can thicken and have a reduced capacity for urine. If the bladder is not completely empty, residual urine can remain, causing germs to settle on the bladder wall. This can cause infections, which can encourage the formation of bladder stones. If left untreated, a severe infection can damage the bladder and kidneys or even spread to the bloodstream leading to sepsis.
Our Prostate Specialists
David Mobley, MD, is our affiliated prostate specialist at American Prostate Centers. Dr. Mobley is double board-certified in Diagnostic Radiology and Vascular and Interventional Radiology. He has more than 10 years of experience performing minimally invasive image-guided endovascular treatments and is one of the small group of physicians in the nation who can expertly perform PAE.
What Our Patients Are Saying
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