Side View: Enlarged Prostate
(BPH) Squeezes Urethra and
Bladder Wall Is Thickened

Symptoms of BPH

-Weak urinary stream
-Sense of incomplete bladder emptying
-Difficulty in starting urination
-Frequent urination
-Urgency (difficulty in postponing urination)
-Awakening frequently at night to urinate
-Interruption of urine stream (stopping and starting)

In a small percentage of men, blockage from BPH may lead to repeated urinary tract infections, acute urinary retention or gradual bladder and/or kidney damage.

Diagnosis of BPH

Digital Rectal Examination (DRE)

This examination enables the physician to estimate whether the prostate is enlarged or has lumps or other areas of abnormal texture.

Additional tests depending on symptoms:
-Blood tests can help detect kidney damage and diagnose cancer
-Urine flow study to measure the speed of urine flow
-Residual urine study to measure urine left in the bladder after urinating
-Plain x-ray
-Ultrasound of kidneys and prostate

Treatment of BPH
-BPH requires treatment only if symptoms are bothersome or urinary function is affected

-If you have BPH but are not bothered by symptoms, you and your doctor may choose a program of "watchful waiting" involving yearly or more frequent checkups

Surgical Treatment
-Transurethral resection of the prostate (TURP) involves removal of the innermost core of the prostate through the urethra so no incision is necessary

-Transurethral incision of the prostate (TUIP) involves making cuts in the prostate instead of removing prostate tissue

-Open prostatectomy may be necessary if the prostate is very large. An incision in the abdomen is made to remove the inner core of the prostate

Non-surgical Treatment
-Medications like Alpha blocker can relax the prostate

-Newly emerging medications like 5 alpha reductase inhibitors partially shrinks the prostate

-Balloon dilatation of the urethra enlarges the passage of the urethra

-Microwave/Heat therapy

-Prostatic stents

It is important to be aware that surgery for BPH does not eliminate your risk of prostate cancer. Prostate cancer usually begins in the outer layer of the prostate, which is not the portion removed during surgery for BPH.

Yearly rectal examinations are just as important for men who have had surgery for BPH as for men who have not.