Benign prostatic hyperplasia is a non‑cancerous enlargement of the prostate, common in older men. Its symptoms include difficulty urinating and a feeling of incomplete bladder emptying. Although it has no definitive cure, the condition can be treated. Learn more!
Benign prostatic hyperplasia (BPH) is a relatively common condition. In other words, most men may develop some degree of BPH at some point in life.
According to data from a study published in the International Neurourology Journal (2017), the prevalence of BPH increases progressively with age: about 8 % of men aged 40–49 already show signs of the condition. This number rises to 50 % between 50 and 60 years and exceeds 80 % in men over 80.
While the condition may cause concern, there are different treatment options available. Keep reading to learn more about BPH.
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH) is a condition that affects the prostate—a male reproductive gland located near the bladder and urethra.
It is characterized by benign enlargement of the prostate as men age and is popularly known as an “enlarged prostate.”
What causes benign prostatic hyperplasia?
This medical condition consists of an increase in the number of prostate cells. It is still not exactly known why this occurs, but everything indicates that it is related to hormonal factors—mainly testosterone and dihydrotestosterone (DHT).
Especially after 50 years of age, the production of these substances tends to decrease, favoring gland growth. Not by chance, BPH affects about 50 % of men in this age group, and up to 80 % of patients over 90 can present benign prostate enlargement, according to the Brazilian Society of Urology (SBU).
Genetic factors and family history can also influence the development of the condition.
What are the common symptoms of benign prostatic hyperplasia?
The most common symptoms of BPH include the following conditions:
- Difficulty starting urination;
- Feeling of incomplete bladder emptying;
- Increased urinary frequency, including at night (nocturia);
- Need to urinate becomes increasingly urgent and sudden;
- Weak urinary stream;
- Dribbling at the end of urination;
- Urinary infections (in some cases, the symptoms can cause infections in the urinary tract such as urethra, bladder, kidneys);
- Changes in the muscular wall of the bladder.
Does benign prostatic hyperplasia have a cure?
Although not dangerous, BPH can be managed with medical follow‑up, especially in cases in which urinary symptoms impact quality of life. In such situations, the urologist will be able to assess the most appropriate course of action.
Risk factors for BPH
Several factors can increase the risk of developing benign prostatic hyperplasia, as listed below:
- Age: the risk increases significantly with aging;
- Family history: having close relatives with BPH can increase the risk;
- Hormonal changes: imbalances, especially related to testosterone and its derivatives;
- Obesity: excess weight may be associated with higher risk;
- Sedentary lifestyle: lack of regular physical activity may contribute;
- Chronic diseases: conditions such as diabetes and heart disease are linked to greater risk;
- Diet: a diet high in fats and low in fruits and vegetables can increase risk.
How is the diagnosis made?
Diagnosis of BPH usually involves the following steps:
- Medical history and physical exam, including digital rectal examination;
- Urine and blood tests to rule out other conditions;
- Imaging exams such as ultrasound;
- Uroflowmetry (measurement of urinary flow);
- Cystoscopy (visual examination of the bladder and urethra).
Possible complications of BPH
If left untreated, benign prostatic hyperplasia can cause complications in some cases. A
s the prostate grows, it can compress the urethra and hinder urine flow, leading to difficulty urinating and acute urinary retention—which is painful and requires medical urgency.
There is also a risk of secondary complications, such as recurrent urinary infections, bladder stone formation and even progressive kidney damage in severe cases.
Treatments indicated for BPH
There are several treatments for BPH, and only a urology consultation can determine the best one after a thorough patient analysis. Below are the main available treatments.
Medications
- Alpha‑blockers: relax the muscles of the prostate and bladder neck, making urination easier. Examples include tamsulosin, alfuzosin and doxazosin;
- 5‑alpha‑reductase inhibitors: reduce prostate size by blocking the conversion of testosterone to dihydrotestosterone (DHT). Examples include finasteride and dutasteride;
- Combination therapy: sometimes a combination of alpha‑blockers and 5‑alpha‑reductase inhibitors is prescribed for better results;
- Antibiotics: may be prescribed if there is an associated urinary infection;
- Anticholinergics: used to relieve overactive‑bladder symptoms that may coexist with BPH;
Surgery
- Transurethral resection of the prostate (TURP): the most common procedure, where part of the prostate is removed through the urethra;
- Transurethral incision of the prostate (TUIP): similar to TURP but involves small incisions in the prostate to relieve obstruction;
- Open or robotic‑assisted prostatectomy: used for very large prostates, where part of the gland is removed through an abdominal incision.
How to prevent benign prostatic hyperplasia?
The disease cannot be completely prevented, but early diagnosis and monitoring can avoid surgical treatment. From age 50 on, a man should see a urologist at least once a year.
In addition to checking sexual health, the doctor performs the digital rectal exam to assess prostate size, which also allows early detection of prostate cancer.
Other tests can also be requested, such as PSA to assess for tumors, urine tests for infection or blood, and ultrasound to check prostate shape and density.
Is BPH the same as prostate cancer?
No, benign prostatic hyperplasia and prostate cancer are different conditions, although both affect the prostate.
BPH is a non‑cancerous enlargement that often occurs due to aging and hormonal changes. It is benign and, although it does not directly threaten life, can significantly impact male quality of life.
Prostate cancer, on the other hand, is a malignant condition characterized by abnormal cell growth in the prostate that can spread to other parts of the body (metastasis).
Initially, prostate cancer may be asymptomatic, but advanced symptoms include difficulty urinating, blood in urine, bone pain, weight loss and fatigue.
Unlike BPH, prostate cancer can be life‑threatening if not detected and treated early.
Despite similar initial symptoms, such as difficulty urinating, BPH and prostate cancer require different approaches for diagnosis and treatment.
Does benign prostatic hyperplasia raise PSA?
Yes, BPH can raise PSA (prostate‑specific antigen) levels in the blood.
The PSA is a protein produced by prostate cells, and its levels can be elevated in various conditions, including BPH. As the prostate enlarges due to BPH, PSA production can also increase.
Thus, hyperplasia can damage or irritate prostate cells, leading to more PSA in the bloodstream.
An altered PSA may indicate BPH, but it can also be a sign of prostate cancer or other conditions. Therefore, regular PSA monitoring is important for prostate health.
Can benign prostatic hyperplasia affect sexual function?
Yes, BPH can affect sexual function in several ways.
Constant anxiety and discomfort caused by urinary urgency and the feeling of incomplete bladder emptying can impact sexual desire and the ability to maintain an erection.
Besides psychological impacts, there is a direct relationship between BPH and erectile function.
Prostate enlargement can cause inflammation, interfere with blood flow and damage genital nerves, which may harm erection and contribute to erectile dysfunction.
In addition, BPH treatments such as medications and surgeries may have sexual dysfunction as side effects. The drugs used may cause retrograde ejaculation and erectile dysfunction.
Noticing erectile dysfunction symptoms? Seek medical help
Difficulty obtaining or maintaining an erection, loss of firmness, decreased libido or insecurity during intercourse may indicate that something is not functioning well in the body.
These signs, although common with aging, should not be considered normal. Early investigation of symptoms can broaden clinical approaches and improve management of their impact on sexual life.
If you are noticing these signs, contact Dr. Paulo Egydio, a urologist with more than 25 years of experience in treating male sexual dysfunctions. In case of doubts, it is important to seek a qualified professional for individualized evaluation.
Read also
- What is penile fracture?
- Surgery for Peyronie’s Disease: Risks and Recommendations
- Egydio’s Technique: Peyronie Disease Treatment
- Does the Egydio Technique Work for Every Penile Curvature?
- Implante de Prótese Peniana | Dr. Paulo Egydio
- Does Small Penis Exist? Check When Size Is a Concern
- 7 Simple Habits to Prevent Prostate Cancer
- Can People with a Penile Prosthesis Play Sports?
- How to Enlarge the Penis: Understanding the Options
- 6 Causes of Penis Fissures: Treatments and Care Tips
