Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), the enlargement of the prostate gland causing bothersome urinary symptoms, is very common condition in middle-aged and older men. Symptoms may begin in some men as early 40 years; most men do not experience symptoms until their 50s and 60s. By 80, it is highly likely that a man will it to some degree or another.
BPH is not a cancerous condition but a progressive benign enlargement of the prostate.

While BPH is not associated with the development of cancer, the two often accompany each other. Distinguishing between them is an important part of any evaluation.

The most common symptoms of BPH are:

• An urgency to urinate
• The  need to urinate several times a night
• A slow urinary stream 
• A sense that the bladder isn’t quite empty after urination.
• Having to “push” to start urination
• Having to wait a long time begin urinating

These symptoms may be accompanied by blood in the urine. When symptoms become severe, men may experience incontinence, an inability to hold urination long enough find a toilet. Some may stop urinating entirely - a situation referred to as urinary retention. This condition is frequently associated with kidney damage and must be considered an emergency situation and medical help should be sought immediately. Usualy, once an initial evaluation is completed, the symptoms of BPH can be addressed electively, guided by a patient's desire for treatment and  by quality of life issues.

The symptoms of BPH occur because of prostate gland’s location just below the bladder. Urine must pass through it on its way out of the body. When BPH enlarges the prostate, it creates an obstruction to flow, which slows down the urine stream, makes the bladder work harder to empty, and causes the it to empty incompletely. This leads to residual urine in the bladder after urination. If left untreated, the bladder undergoes changes from constantly fighting the obstructing prostate, leading to worsening symptoms, urinary tract infection, and even kidney problems.