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 from the bladder to the outside of the body.
An enlarged prostate puts pressure on the urethra and can make it difficult for urine to pass. Eventually, the urethra may become completely closed off.
Treatment is not needed for mild cases. Most men with BPH eventually request medical intervention to help with urinary symptoms.
Medication is often the first line of treatment to help reduce urinary symptoms. Medication options include:
5 alpha-reductase inhibitors—to shrink the prostate, which may decrease some urination problems
Alpha-blockers—to relax the muscles around the neck of the bladder and the prostate to improve urine flow
Antimuscarinics—to relax the bladder muscles, which helps to reduce the urge to urinate frequently
Phosphodiesterase-5 enzyme inhibitor —
medication that can also improve the symptoms of BPH
Your doctor may also recommend avoiding certain medications. For example, decongestant drugs containing alpha-agonists such as pseudoephedrine can worsen BPH symptoms.
Minimally Invasive Interventions
Minimally invasive procedures can be through the urethra. This type of surgery generally has shorter recovery time and less risk of damage to surrounding tissue than open surgeries. These options may be used if medications were not able to reduce symptoms but surgery is not needed. Procedure options include:
Transurethral microwave thermotherapy (TUMT)—uses microwaves to destroy excess prostate tissue
Transurethral laser therapy—uses highly focused laser energy to remove prostate tissue
Urolift—small devices are implanted to hold the prostate tissue out of the way of the urethra
Transurethral RF thermal therapy—uses heated water vapor to destroy extra prostate tissue
Prostate enlargement occurs naturally with age. It is more common in men with obesity and low HDL cholesterol levels. Maintaining a healthy weight and eating a healthful diet may prevent prostate enlargement.
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Last reviewed September 2018 by
EBSCO Medical Review Board
Rimas Lukas, MD Last Updated: 11/15/2017