Benign Prostatic Hyperplasia (BPH)
What is BPH / LUTS?
Benign prostatic hyperplasia (BPH) is a common urological condition caused by the non-cancerous enlargement of the prostate gland as men get older. As the prostate enlarges, it can squeeze down on the urethra. The symptoms associated with BPH are known as lower urinary tract symptoms. This can cause men to have trouble urinating and leads to symptoms of BPH. Ths symptoms associated with BPH are known as lower urinary tract symptoms (LUTS).
What are the risk factors for BPH?
Risk factors for developing BPH include:
- Lack of physical activity
- Erectile dysfunction
- Increasing age
- Family history of BPH
What are the symptoms associated with BPH?
Since the prostate is just below thebladder, its enlargement can result in symptoms that irritate or obstruct the bladder. Common symptoms are:
- The need to frequently empty the bladder, especially at night
- Difficulty in beginning to urinate
- Dribbling after urination ends
- Decreased size and strength of the urine stream
- Sensation that the bladder is not empty, even after you are done urinating
- Inability to postpone urination once the urge to urinate begins
- Pushing or straining in order to urinate
In extreme cases, being unable to urinate at all, which is an emergency that requires prompt attention.
How is BPH diagnosed?
When a doctor evaluates someone for possible BPH, the evaluation will typically consist of a thorough medical history, an examination of the urinary sediment (urinalysis) a physical examination (including digital rectal exam or DRE), and use of the AUA BPH Symptom Score Index. In addition, the doctor will generally do a urine test called a urinalysis. There are a series of other studies that may or may not be offered to a patient being evaluated for BPH depending on the patient’s current medial condition. These include:
- Prostate specific antigen (PSA) – a blood test to screen for prostate cancer
- Urinary cytology – a urine test to screen for bladder cancer
- A measurement of post-void residual volume (PVR), the amount of urine left in the bladder after urinating
- Uroflowmetry, or urine flow study, a measure of how fast urine flows when a man urinates
- Cystoscopy – a direct look in the urethra and / or bladder using a small flexible scope
- Urodynamic pressure-flow study – tests the pressures inside the bladder during urination
- Ultrasound of the kidney or the prostate – to view the enlargement