WHAT YOU NEED TO KNOW:

What is benign prostatic hypertrophy? Benign prostatic hypertrophy (BPH) is a condition that causes your prostate gland to grow larger than normal. The prostate gland is the male sex gland that produces a fluid that is part of semen. It is about the size of a walnut and it is located under the bladder. As the prostate grows, it can squeeze the urethra. This can block urine flow and cause urinary problems.

What causes BPH? It is not known what causes BPH. It may be just part of getting older. BPH is very common in men over 45 years of age, but rarely causes problems before age 60. Some healthcare providers believe it is caused by a change in hormone levels as men get older.

What are the signs and symptoms of BPH?

• Feeling like you have not emptied your bladder
  
  
• Feeling the need to urinate right away
  
  
• Urine does not flow right away when you start to urinate or stops and starts again
  
  
• Frequent urination, especially at night
  
  
• Weak urine stream
  
  
• Blood in your urine

How is BPH diagnosed?

• Blood tests: Blood tests such as prostate specific antigen (PSA) measurement may be done. The amount of PSA in your blood may go up if you have BPH.
  
  
• Cystoscopy: A cystoscopy allows caregivers to look for problems inside your bladder. A cystoscope is put into your bladder through your urethra. The urethra is the tube that urine flows through when you urinate. The cystoscope is a long tube with a lens and a light on the end. The scope may be hooked to a camera or monitor, and pictures may be taken. A tissue sample may also be taken during your cystoscopy. During this test, small tumors may be removed or bleeding may be stopped.
  
  
• Digital rectal examination: Your healthcare provider will use his finger to feel if your prostate is larger than normal.
  
  
• Prostate biopsy: A small piece of the prostate is removed and sent to a lab for tests.
  
  
• Transrectal ultrasound: Sound waves are used to show pictures of your prostate on a monitor.
  
  
• Urine tests:
  • Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.
    
    
  • Residual urine measurement: Healthcare providers may use a catheter to measure how much urine is left in your bladder after you urinate.
    
    
  • Flow rate recording: This is a test that measures the speed of your urine stream.

How is BPH treated?

• Medicines:
  • Alpha blockers: This medicine relaxes the muscles in your prostate and bladder. It may help you urinate more easily.
    
    
  • 5 alpha reductase inhibitors: These medicines block the production of a hormone that causes the prostate to get larger. It may help to slow the growth of the prostate or shrink the prostate.
  
  
• Stent: A stent is a short, tiny mesh tube that is put into the urethra to hold it open.
  
  
• Surgery: You may need surgery to remove your prostate.
  
  
• Other procedures: The prostate may be made smaller by a procedure such as a transurethral needle ablation (TUNA) or microwave heat treatment. You may also have a laser procedure called interstitial laser coagulation (ILC) to remove the prostate.

What are the risks of BPH?

• Surgery to remove your prostate may cause you to bleed more than expected or get an infection. You may also have trouble controlling your bladder. This may cause you to leak urine. You may also have sudden strong urges to urinate that make it hard for you to hold your urine.
  
  
• Without treatment, you may have other health problems. If urine stays in your bladder too long, you may develop a urinary infection or bladder stones. Small blood vessels in the bladder and prostate may start to bleed because you strain more when you urinate. The urethra may suddenly become blocked off, making it even harder to urinate. Over time, your kidneys can be damaged as urine backs up from the bladder and into the kidneys.

How can I manage BPH?

• Do not let your bladder get too full before you empty it. Urinate when you feel the urge.
  
  
• Limit alcohol. Do not drink large amounts of any liquid at one time.
  
  
• Decrease the amount of salt you eat. Examples of salty foods are chips, cured meats, and canned soups. Do not use table salt.
  
  
• Healthcare providers may tell you not to eat spicy foods such as chilli peppers. This may help you find out if spicy food makes your BPH symptoms worse.
  
  
• You may have sex if you feel well.

When should I contact my healthcare provider?

• There is a large amount of blood in your urine.
  
  
• Your signs and symptoms get worse.
  
  
• You have a fever.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

• You are unable to urinate.
  
  
• Your bladder feels very full and painful.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.