by Rick Alan
Related Media: Transurethral Resection of the Prostate (TURP)
Benign prostatic hyperplasia (BPH) is an enlargement of the prostate. The prostate is usually a walnut-sized gland located at the neck of the bladder. It surrounds the urethra. The gland is part of the male reproductive system. The enlargement is not due to cancer.
The exact cause of BPH is unknown. It may be related to changes in hormone levels as men age. Eventually, the prostate becomes so enlarged that it puts pressure on the urethra. This causes the urethra to narrow or close completely.
A risk factor is something that increases your chance of getting a disease or condition. The main risk factor for BPH is being over 50 years old.
Narrowing of the urethra caused by growth of the prostate causes the symptoms of BPH. Symptoms usually increase in severity over time.
Symptoms include:
BPH diagnosis is based on:
Other tests may include:
Testing for prostate specific antigen (PSA) is often used to screen for prostate cancer. However, BPH may cause a lesser elevation in PSA levels . This can raise false concerns about the presence of cancer.
Treatment is not needed for mild cases. Most men with BPH eventually request medical intervention.
Treatments include:
Medicines prescribed to treat BPH include:
Each group of medicines has different side effects. Enzyme inhibitors may cause decreased sexual desire and problems with erection. Alpha-blockers may cause decreased blood pressure, dizziness, and stuffy nose. Antimuscarinics can cause dry mouth, constipation, dry eyes, trouble emptying the bladder, and confusion.
If you have BPH, you should not take decongestant drugs containing alpha-agonists (eg, pseudoephedrine ). These drugs can worsen BPH symptoms.
These are used when drugs are ineffective, but the patient is not ready for surgery. Nonsurgical treatments include:
Surgical procedures include:
Examples of herbal products that have been studied as a possible BPH treatments include:
If you are diagnosed with BPH, follow your doctor's instructions .
Prostate enlargement occurs naturally with age. There are no specific prevention steps.
National Kidney and Urologic Diseases Clearinghouse
http://kidney.niddk.nih.gov/
The Prostate Institute of America
http://pioa.org/
Prostate Cancer Research Institute
http://prostate-cancer.org/
Canadian Urological Association
http://www.cua.org/
Prostate Centre
http://www.prostatecentre.ca/
Berkow R, et al. The Merck Manual of Medical Information. 17th ed. Simon and Schuster, Inc.; 2000.
Beta-sitosterol. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 2011. Accessed October 7, 2011.
Fagelman E, Lowe FC. Saw palmetto berry as a treatment for BPH. Rev Urol. 2001 Summer;3(3):134-8.
Fried NM. New laser treatment approaches for benign prostatic hyperplasia. Curr Urol Rep. 2007 Jan;8(1):47-52.
Guideline on the management of benign prostatic hyperplasia. American Urological Association. Available at: http://www.auanet.org/content/clinical-practice-guidelines/clinical-guidelines.cfm?sub=bph. Updated 2006. Accessed June 30, 2008.
Greco KA, McVary KT. The role of combination medical therapy in benign prostatic hyperplasia. Int J Impot Res. 2008 Dec;20 Suppl 3:S33-43.
Marberger M. Drug insight: 5-alpha-reductase inhibitors for the treatment of benign prostatic hyperplasia. Nat Clin Pract Urol. 2006 Sep;3(9):495-503.
Prostate enlargement: Benign prostatic hyperplasia. National Kidney Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/. Accessed July 26, 2010.
Pygeum. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 2011. Accessed October 7, 2011.
Roehrborn CG, Siami P, Barkin J, et al; CombAT Study Group. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010 Jan;57(1):123-31. Epub 2009 Sep 19.
Saw palmetto. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/. Updated August 2011. Accessed October 7, 2011.
Ulbricht C, Basch E, Bent S, et al. Evidence-based systematic review of saw palmetto by the Natural Standard Research Collaboration. J Soc Integr Oncol. 2006;4(4):170-86.
10/7/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Barry MJ, Meleth S, Lee JY, et al. Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. JAMA. 2011;306(12):1344-1351.
10/14/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: US Food and Drug Administration. FDA approves Cialis to treat benign prostatic hyperplasia. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm274642.htm. Updated October 6, 2011. Accessed October 14, 2011.
Last reviewed September 2012 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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