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Benign Prostatic Hyperplasia (BPH)


What is benign prostatic hyperplasia (BPH)?BPH (also referred to as benign prostatic hypertrophy) is a condition in which the prostate gland becomes very enlarged and may cause problems associated with urination. BPH can raise PSA (prostate-specific antigen) levels two to three times higher than the normal level. An increased PSA level does not indicate cancer, but the higher the PSA level, the higher the chance of having cancer.

Some of the signs of BPH and prostate cancer are the same, however, 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. Therefore, the National Cancer Institute and the American Cancer Society recommend that all men over 50 consult their physicians about having a digital rectal and PSA examination once a year to screen for prostate cancer.


How does BPH occur?
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.

The continuing enlargement of the prostate does not usually cause problems until later in life. However, the second period of growth may, many years later, result in BPH.


What happens when the prostate enlarges?
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 and leave 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.


What are symptoms of BPH?
The following are the most common symptoms of benign prostatic hyperplasia. However, each individual may experience symptoms differently. Symptoms may include:

  • leaking or dribbling of urine
  • more frequent urination, especially at night
  • urgency to urinate
  • urine retention - inability to urinate.
  • a hesitant, interrupted, weak stream of urine


These problems may lead to one/more of the following:

  • incontinence
  • kidney damage
  • bladder damage
  • urinary tract infections
  • bladder stones
Eventually, BPH symptoms usually require some kind of treatment. When the gland is just 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 your physician after careful evaluation of your individual condition. Regular checkups are important, however, to watch for developing problems.

Lifestyle management for BPH may include Kegel exercises

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 is recommended that men with BPH repeat five to 15 contractions, holding each for 10 seconds, three to five times a day. Consult your physician for more information.

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