Enlarged Prostate (BPH):
Causes, Symptoms, Treatments

Published 2020/02/07

BPH—benign prostatic hyperplasia—is the non-cancerous enlargement of the prostate gland. BPH is the most common disease in aging men that lead to lower urinary tract symptoms: 50% of men in their 50’s will have BPH, and 80% in their 80’s.

Although the prostate enlargement itself is harmless, it can lead to other problems such as urinary retention, a condition that increases the risk of UTI, bladder stones, bladder damage, and kidney damage. Intermittent catheters are often prescribed to manage urinary retention.

This article will help you understand more of BPH’s causes, symptoms, and treatments.

What is the prostate?

The prostate is a ping-pong-ball-sized gland that sits below the bladder neck, where the urethra meets the bladder. The bladder is a muscular sac in the pelvis that relaxes to retain urine, and contracts to squeeze urine out. The urethra is a tube that leads urine away from the bladder to the outside of the body.

The prostate wraps around the urethra, and it sits under the bladder and in front of the rectum. The prostate produces seminal fluids, which mixes with the sperm produced by the testes to help it survive.

Cause of Enlarged Prostate (BPH)

The prostate goes through two major growth phases in a man’s lifetime. The first one occurs in puberty when it grows to twice its size, the second growth phase occurs around age 25 and continues as men age.

This kind of natural prostate growth is called BPH, benign prostatic hyperplasia, which is different from other forms of prostate enlargement that are due to infections, inflammation, or cancer.

How does BPH cause
urinary retention?

Since the prostate gland surrounds the urethra—the tube that lets urine exit the body—when the prostate enlarges, it constricts or obstructs the urethra, not letting urine flow freely out of the bladder. This causes incomplete emptying of the bladder where urine remains in the bladder even after an attempt at urination.

The retained urine can increase the chance of a bladder infection since bacteria in the urine are not flushed out in a timely manner and are thus allowed to multiply. In severe cases, the urine in the bladder can reflux into the kidney through the ureters causing kidney damage and infections, which can be deadly.

Symptoms of BPH

Symptoms of BPH include symptoms of urinary retention:

Difficulty starting stream; weak and broken stream
Frequent urination with little volume, immediate need to urinate right after finishing
Feeling like the bladder is not completely emptied after urination
Constant pressure and discomfort in the lower abdomen and urinary tract

As a result of urinary retention, you may get UTIs; here are some symptoms of UTIs:

Bloody, cloudy, foul-smelling urine
burning, painful urination
Frequent strong urge to urinate with little output volume

Symptoms of kidney infection, which is an infection of the upper urinary tract, can have the above symptoms plus fever, chills, nausea, vomiting, and pain in the back, flank, or groin.

If you notice these symptoms, you should contact your doctor to get a formal diagnosis. If you have signs of kidney infection, you should go to the emergency room.

Treatment for BPH

There are many courses of treatment for BPH. One common method is to self-catheterize with intermittent catheters. Intermittent catheters cannot make the prostate smaller, but they treat the symptom of urinary retention by helping the user drain their bladder completely.

For people with mild symptoms, doctors may not prescribe any active treatments and only ask patients to closely monitor their BPH symptoms. If BPH symptoms worsen, that’s when treatment will begin.

Medication can also help treat BPH. Based on your circumstance, your doctor may prescribe you with alpha blockers, which relaxes the prostate and bladder to make the passage of urine easier.

Your doctor may also prescribe 5-alpha reductase inhibitors, a medicine that inhibits the production of DHT, a hormone thought to be linked to prostate growth. Sometimes, a combination of alpha blockers and 5-alpha reductase inhibitors is prescribed.

For people with moderate to severe BPH, minimally invasive surgery can lift the prostate out of the way of the urethra, or reduce the size of the prostate by destroying prostate tissues.

For diagnosis and treatment, please consult a medical professional. This article does not serve as medical advice.

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