Sept. 21, 2023 | The prostate is a gland in the male reproductive system. It lies just below the bladder and makes the fluid that nourishes and transports sperm. As men age, the prostate gland slowly gets bigger. As it gets bigger, it may press on the urethra, which can cause a slower, weaker urine stream. An enlarged prostate, a condition known as benign prostatic hyperplasia, is when your prostate gland becomes larger than normal. Fortunately, BPH isn’t a form of cancer and it doesn’t increase your risk of getting prostate cancer but it is the most common prostate condition in people over the age of 50. BPH is also called benign prostatic hypertrophy or benign prostatic obstruction. Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder can cause many of the urinary problems you may have with BPH.

Sept. 21, 2023 | The exact cause of benign prostatic hyperplasia, or BPH, remains a mystery to the medical world. Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that BPH may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth. Another theory focuses on dihydrotestosterone, or DHT, a male hormone that plays a role in prostate development. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop BPH.

Sept. 21, 2023 | The symptoms of benign prostatic hyperplasia most often come from a blocked urethra or a bladder that is overworked from trying to pass urine through the blockage. Dr. Tim Langford, chairman of the UAMS Department of Urology, says the size of the prostate does not always determine the severity of the blockage or any symptoms. Less than half of all men with BPH have lower urinary tract symptoms, which can include the need to urinate frequently and the inability to delay urination. Urinary incontinence, the accidental loss of urine, is another common symptom of BPH. According to Dr. Langford, sometimes men may not know they have a blockage until they cannot urinate. This condition, called acute urinary retention, can result from taking cold or allergy medications that contain decongestants, such as pseudoephedrine and oxymetazoline. A potential side effect of these medications may prevent the bladder neck from relaxing and releasing urine.

Sept. 21, 2023 | If you experience any of the symptoms of benign prostatic hyperplasia, it’s important that you consult with an expert on the condition. Dr. Tim Langford, who sees patients at the recently opened UAMS Urology Center, says certain tests can confirm an enlarged prostate. A prostate-specific antigen, or PSA, blood test measures the level of the PSA protein produced in the prostate. PSA levels go up when the prostate becomes enlarged. But higher PSA levels can also be due to recent procedures, illnesses, surgery or prostate cancer. A urinary flow test measures how strong your urine flow is and how much urine you pass. Test results can show over time whether your condition is getting better or worse. A transrectal ultrasound may be ordered to measure and check the prostate. A prostate biopsy uses the ultrasound to take tissue samples of the prostate. Checking the tissue can help a urology specialist determine if you have prostate cancer.

Sept. 21, 2023 | Because benign prostatic hyperplasia is not a life-threatening condition, some men may not need treatment for it unless their symptoms are affecting their quality of life. If BPH symptoms become bothersome or present a health risk, a urologist may recommend lifestyle changes such as a reduced intake of liquids or a reduction of caffeinated beverages or alcohol. Medications such as alpha blockers or phosphodiesterase-5 inhibitors can stop the growth of or shrink the prostate. Minimally invasive surgical procedures can destroy enlarged prostate tissue or widen the urethra, which can help relieve blockage and urinary retention caused by BPH. For long-term treatment of BPH, a urologist may recommend removing enlarged prostate tissue or making cuts in the prostate to widen the urethra. A urology expert can explain the possible benefits and side effects of your treatment options so you can decide what’s best for you.