Benign Prostatic Hyperplasia Facts

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Doctor and male patient

Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland that may cause problems with urination.

Some of the signs of BPH and prostate cancer are the same, but having BPH does not seem to increase the chances of developing prostate cancer. A man who has BPH may also have undetected prostate cancer at the same time or may develop prostate cancer in the future.

The National Cancer Institute and the American Cancer Society recommend that all men older than 50 talk with their doctors about having an annual digital rectal examination (DRE) and measure PSA (prostate-specific antigen) levels in the blood every 2 to 4 years to screen for prostate cancer. Because the DRE can falsely elevate PSA levels, the DRE and PSA test should be performed on separate visits. 

In a man's life, the prostate goes through two main periods of growth. In early puberty, the prostate doubles in size. Then, around age 25, the prostate begins to grow again and continues to grow throughout most of a man's life. BPH rarely causes symptoms before age 40, but more than half of men in their 60s have some symptoms of BPH. As many as 90% of men in their 70s and 80s have some symptoms of BPH.

As the prostate enlarges, it presses against the urethra and interferes with urination. At the same time, the bladder wall becomes thicker and irritated, and begins to contract—even when it contains small amounts of urine, which causes more frequent urination. And, as the bladder continues to weaken, it may not empty completely, leaving some urine behind. Blocking or narrowing of the urethra by the prostate and partial emptying of the bladder cause many of the problems associated with BPH.

Diagnosing BPH before an advanced stage can lower the risk of developing complications. A delay in treatment could lead to permanent bladder damage. In addition to a complete medical history and physical exam, there are several diagnostic procedures for BPH that include physical exams and ultrasounds.

Eventually, BPH symptoms usually require some kind of treatment in many men. When the gland is only mildly enlarged, treatment may not be needed, since research has shown that some of the symptoms of BPH clear up without treatment in some mild cases. This determination can only be made by a physician after careful evaluation of individual conditions. Regular checkups are important, however, to watch for developing problems.

Fortunately, BPH can be managed with the help of certain lifestyle changes involving diet, medication, and exercise.

Certain foods help and others hurt. Increasing intake of soy, drinking green tea, and taking saw palmetto supplements may benefit the prostate, although this isn't yet proved. Also, avoiding or decreasing intake of alcohol, coffee, and other fluids, particularly after dinner, is often helpful for easing symptoms.

Medications can worsen symptoms. Decongestants and antihistamines can slow urine flow in some men with BPH. Some antidepressants and diuretics can also aggravate symptoms of BPH.

Kegel exercises help. Repeatedly tightening and releasing the pelvic muscle, also known as Kegel exercises, is helpful in preventing urine leakage. Physicians recommend practicing this exercise while urinating in order to isolate the specific muscle. To perform a Kegel, contract the muscle until the flow of urine decreases or stops, and then release the muscle. It's recommended that men with BPH repeat five to 15 contractions, holding each for 10 seconds, three to five times a day.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 May 10
National Institute of Diabetes and Digestive and Kidney Diseases (http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/);

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