Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH)       

BPH Specialists - Make an appointment

• Howard Adler, MD
• Frank Darras, MD
• David Schulsinger, MD
• Scott Herfel, PA

What is the prostate and where is it located in the body?
The prostate is a walnut-sized gland located just below the bladder. It surrounds part of the urethra, a tube that carries urine from the bladder during urination.

What is the function of the Prostate Gland?
The primary role of the prostate is to provide part of the fluid necessary for ejaculation. This fluid helps to carry and nourish sperm, aiding in the process of conception.

What happens when the prostate enlarges?
In most men, the prostate begins to increase in size by 45 years of age.  It can continue to grow for the rest of a man's life.  The prostate gland surrounds a section of the urethra, the tube which carries urine from the bladder through the penis during urination.  The activity of a key hormone, dihydrotestosterone (DHT), causes the prostate to start growing. As the prostate continues to enlarge, it can squeeze the urethra (like pinching a straw) and cause urinary problems.

Normal prostate enlargement is referred to as Benign Prostatic Hyperplasia (BPH).  BPH can interfere with the normal flow of urine and cause uncomfortable symptoms.  Prostate enlargement, or BPH, is a noncancerous condition.   It is not cancer, nor does it lead to cancer.  However, a man may have BPH and prostate cancer at the same time.

Does everyone with an enlarged prostate have bothersome symptoms?
No. Studies show that as men age and as their prostates increase in size, symptoms occur more often and may become more severe. You may be symptom-free, or have symptoms that are only mildly disturbing.

What are the most common symptoms of BPH?
When BPH interferes with urine flow, the following symptoms may occur:

1. A need to urinate often (especially disturbing at night)
2. A weak urinary flow, dribbling of urine.
3. A feeling that bladder is full, even right after urinating.
4. A feeling of delay or hesitation when you start to urinate
5. A feeling that you must urinate right away
6. Continuing pain in the lower back, pelvis or upper thighs

The symptoms caused by BPH affect the urethra and eventually the bladder.   In the early phase of prostate enlargement, the bladder muscle contracts more forcefully to force urine through the narrowed urethra.  Over time, the forceful contraction causes the bladder muscle to strengthen, thicken, and become overly sensitive.  In some cases, as prostate enlargement progresses, the urethra is squeezed more tightly, and the bladder muscle is less able able to force urine through the narrowed urethra.  Therefore, the bladder may not empty completely.  In turn, this creates an increased need to urinate with more frequency. 

Incomplete emptying of the bladder may lead to urinary track infections (UTI).   If a UTI develops, burning and/or pain during urination is experienced.  Recurrent UTIs, the sudden inability to urinate, or gradual bladder and/or kidney damage occur in a small percentage of men with BPH.  An enlarged prostate can even result in total blockage of the urethra, which is a very serious condition.  

How do some men cope with the symptoms of BPH?
Men with mild symptoms of BPH rarely find a need to modify their daily activities.  However, as symptoms progress, some men experience differing social consequences.  They are forced to stay close to a bathroom, reserve seats on the aisle, wear dark clothing to conceal leakage, nap frequently to make up for loss of sleep at night, and curtail social activities.  These adjustments can make a significant differences in your lifestyle.  A regular urological check-up and consultation with your physician will be very helpful, and is recommended.  

What should every man should do?
According to the American Urological Association (AUA), if you are 40 older, you should have a digital rectal exam as part of your annual check- up. At the time of your examination, openly discuss any changes in urinary habits or bothersome symptoms with your doctor.

What will your doctor will do?
The doctor will perform a digital rectal exam (DRE) and PSA blood test. Since the prostate is located near the rectum, the doctor can feel the prostate by inserting a gloved lubricated finger into your rectum. This simple exam helps the physician determine whether your prostate is enlarged, has lumps or areas of abnormal texture.

Ways to treat symptomatic benign prostate enlargement:
Today, more than ever, is an excellent time to see your doctor. There have been many advances in the treatment of symptomatic benign prostate enlargement. If treatment is appropriate, your doctor now has several options to discuss with you.  Remember, only your health care professional is qualified to evaluate your symptoms and determine possible causes.

Medical Therapies:

• Alpha Blockers: Pills that relax the muscles of the prostate and bladder.  Also improve urine flow.  One benefit of alpha blockers is that they work right away.  
• 5-Alpha Reducatase Inhibitors: Blocks the prodction of BHT.  These pills shrink the prostate.
• Cialis: Used in combination to treat Erectile Disfunction.
• Minimally Invasive Surgeries: Surgery can be done in Ambulatory Center.  These techniques all remove enlarged prostate tissue (using heat, laser) to improve urination.  Also reduce protstate volume.  
  • Greenlight Laser
  • Gyris Saline Turp