Benign Prostate Hyperplasia (BPH)

Benign Prostate Hyperplasia, also called benign prostate hypertrophy, is enlargement of the prostate gland. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so some of the urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH.

Symptoms

  • Hesitant, interrupted, weak urine stream
  • Urgency and leaking or dribbling of urine
  • More frequent urination, especially at night

To diagnose benign prostate hypertrophy, the urologist will do a digital exam by inserting a gloved finger into the rectum in order to palpate (feel) the prostate gland next to the rectum. To rule out cancer as a cause of the urinary symptoms, the urologist may recommend a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer.

Additional examination may include cystoscopy. This test includes the urologist inserting a tube, after numbing the inside of the penis so no pain is felt, to visualize the bladder and urethra. This can allow the physician to determine the degree of enlargement of the prostate gland.

Treatment

Treatments for BPH may include medication to shrink the prostate gland or to stop its enlargement. If the medication does not relieve the patient’s symptoms, the urologist may perform one of several different nonsurgical procedures to remove part of the prostate gland. Simply explained, those include heat, heated water (thermotherapy), radiofrequency energy, or ultrasound.

Surgical treatment of BPH is sometimes necessary. Commonly, the urologist performs a transurethral resection of the prostate (TURP). This surgery requires the patient receive general anesthetic. With TURP, an instrument called a resectoscope is inserted through the penis… cuts the tissue and seals blood vessels.

The urologist may elect to excise or remove part of the prostate gland using a laser. Laser surgery has some advantages as it causes less blood loss and has a quicker recovery period.