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Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The prostate is a walnut-sized gland located at the neck of the bladder. It surrounds the urethra, a tube that carries urine out from the bladder.
An enlarged prostate puts pressure on the urethra. This can make it difficult for urine to pass. The urethra may become completely closed off.
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The exact cause of BPH is unknown. Natural changes in hormone levels due to age may play a role.
It is not due to cancer.
BPH is most likely to occur in men aged 50 years or older. Other things that may increase the risk of BPH are:
The prostate itself does not cause symptoms. A larger prostate can put pressure on the urethra. It will lead to problems with urine flow such as:
Symptoms often get worse over time.
The doctor will ask about symptoms and past health. The prostate may need to be checked if BPH is suspected. A gloved finger is inserted into the rectum. The doctor can feel the size of the prostate through the rectum.
Urine flow may be checked with:
Images of the prostate and urinary tract may be taken with:
BPH does not need treatment if it is not causing symptoms. Most BPH will lead to urinary symptoms at some point. Treatment will be needed to improve urinary symptoms. Treatment choices include:
Medicine is the first line of treatment. Some medication choices include:
Some medicine can make make BPH symptoms worse. Treatment will include avoiding this type of medicine. Decongestant medicine with pseudoephedrine is one example.
Minimally invasive procedures are done through the urethra. They often have shorter recovery times and less tissue damage than open surgeries. It may be done if medicine can no longer manage symptoms. There are different types of procedures such as:
Surgery may be done if medicine or procedures above cannot manage symptoms. The goal is to remove excess prostate tissue or widen the path for urine.
Excess prostate may be removed with:
The urethra may be widened by:
Prostate enlargement is a natural change with age. Problems are more common in those with obesity and low high-density lipoprotein (HDL) "good cholesterol". Keeping a healthy weight and a healthy diet may prevent or slow prostate enlargement.
National Institute of Diabetes and Digestive and Kidney Diseases
Prostate Cancer Research Institute
Canadian Urological Association
The Prostate Centre at The Princess Margaret
American Urological Association (AUA), McVary KT, Roehrborn CG, et al. Management of benign prostatic hyperplasia (BPH) (Revised 2010, reviewed and validity confirmed 2014).
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Last reviewed September 2020 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 9/4/2020