University of Maryland Medical Center (UMMC) defines benign prostatic hyperplasia (BPH), a common condition in older men, as a noncancerous enlargement of the prostate gland. Normally the size of a walnut, with BPH, the prostate gland may become as large as a tennis ball says Merck Manuals.
The prostate is located under the bladder and surrounds the urethra (which empties urine from the bladder). Mayo Clinic describes BPH as the urethra passing through the prostate as if passing through a doughnut hole. When the prostate enlarges, the hole shrinks and begins to block urine flow.
Risk factors for BPH include aging, family history, and ethnic background. It’s more common in black and white men. Some over-the-counter cold and allergy medications can also drastically worsen BPH.
Mayo Clinic lists BPH symptoms as weak urine stream; difficulty starting urination; stopping and starting while urinating; dribbling at the end of urination; frequent or urgent need to urinate; increased frequency of urination at night; straining while urinating; inability to completely empty the bladder; blood in the urine; urinary tract infection; stones forming in the bladder; and impaired kidney function.
Merck Manuals says treatment isn’t necessary unless there are especially bothersome symptoms or complications like urinary tract infections, impaired kidney function, blood in the urine, stones, or urinary retention.
Several treatments are available and include medications, surgery and minimally invasive techniques.
Medication is the most common treatment for moderate BPH. These include, according to UMMC, alpha blockers which cause the bladder muscles to relax, making it easier to urinate, and 5-alpha-reductase inhibitors which shrink the prostate by preventing hormonal changes that cause prostate growth.
NKUDIC says most doctors recommend BPH surgery as the best long-term solution. Transurethral resection of the prostate, says UMMC, is the most common. Surgeons insert a scope through the penis and remove the interior of the prostate piece by piece.
Another procedure, says NKUDIC, is transurethral incision of the prostate.