Benign Prostatic Hyperplasia (BPH) is an enlarged prostate. BPH is not prostate cancer and does not make you more likely to get it. When you have BPH, your prostate squeezes the urethra. This can cause a weak urine stream, dribbling when you’ve finished or a hard time getting urine to come out.
Needing to urinate often (day or night) is a common sign of BPH. The main treatment choices include lifestyle management, medications, minimally invasive treatment or traditional surgeries. The first way to treat BPH is with lifestyle management. Take a step back and find out what lifestyle factors may be adding to your urination symptoms.
It could be fluid intake, and/or too many liquids later in the evening. This treatment option can help a lot of men, but many times, it's not enough. The next step would be to take medications. A class of medications called alpha blockers may help relax some of the basic muscles of the prostate, allowing men to urinate more easily.
Another class of medications commonly used are called phosphodiesterase type 5 inhibitors (PDE5) inhibitors, which may help ease some of the symptoms. A third category of medication are 5-alpha reductase inhibitors. These could help decrease the level of DHT in the prostate, and in doing so, the prostate shrinks down.
If medications don't work, or if the man has side effects from the medication, and they don't want to take pills anymore, then the urologist, at this point, would normally talk to the patient about an surgery. Surgery comes in two broad categories. One is a standard/traditional surgical approach.
These call for general anesthesia and involve some means of getting rid of a part of the prostate blocking the urine flow. The other is a category called minimally invasive surgical treatment where treatments are delivered in a non-invasive, or a minimally invasive, way to the part of the prostate causing the blockage.
Kevin McVary, MD, FACS, is a urologist, and the Director of Men's Health at Loyola University Medical Center in Maywood, Ill.