Hi, I'm Cathy with Level Up RN. In this episode of Ask a Nurse, I'll be answering your questions about benign prostatic hyperplasia, or BPH, such as, what is BPH? What are the symptoms of BPH? And how is BPH diagnosed and treated? Benign prostatic hyperplasia, or BPH, is a condition in males where the prostate gland is enlarged. So benign means not cancerous, and hyperplasia means too much growth. So BPH is a condition where the prostate gland is larger than normal, but not due to cancer. The prostate gland sits under the bladder and surrounds the urethra. The main purpose of the prostate gland is to support fertility by making a fluid that goes into the semen. As a man gets older, hormone changes, including a decrease in testosterone, leads to enlargement of the prostate. And when the prostate gland becomes enlarged, it can push against the bladder and the urethra, causing issues with urination. BPH is extremely common in men over the age of 50. In fact, 50% of men between the ages of 51 and 60 have BPH, and 90% of men over the age of 80 have BPH. Other risk factors that increase the likelihood of developing BPH include a family history of BPH, obesity, heart disease, type 2 diabetes, erectile dysfunction, and a lack of physical activity.
Signs and symptoms of BPH include frequent urination, including at night when you are trying to sleep, urinary urgency, and incontinence. BPH can also make it difficult to start urinating, and it can cause a weak urine stream and also result in dribbling after urination. Other signs and symptoms include pain with ejaculation or with urination, a change in the color or smell of your urine, as well as urinary retention, which is where the bladder doesn't empty completely, which in turn can cause urinary tract infections. To diagnose BPH, your provider will obtain information about your medical history, symptoms, and family history. They may also perform a digital rectal exam. This is where your provider places a gloved finger into the rectum to feel if the prostate gland is enlarged or tender and to check for any other abnormalities. Other tests that may be ordered include a urinalysis, a prostate-specific antigen or PSA blood test, urodynamic testing to see how well you were able to hold and release urine, a cystoscopy, which is a procedure that allows the provider to look inside the urethra and bladder, a transrectal ultrasound, which uses sound waves to create images of the prostate gland, and/or a prostate biopsy to rule out prostate cancer.
Treatment of BPH includes lifestyle changes, medications, minimally invasive procedures, and surgery. For individuals with mild symptoms, lifestyle changes that can help include drinking less fluids before bedtime and/or leaving the house to go in public, cutting back on caffeine and alcohol, which are bladder stimulants, engaging in bladder training, which is basically training the bladder to hold more urine for a longer period of time, and pelvic floor exercises to help decrease urine leakage. Common medications used to treat BPH include tamsulosin, tadalafil, and finasteride. Tamsulosin, which is brand named Flomax, works by relaxing the muscles in the prostate gland, which can help improve urine flow. Tadalafil, which is brand named Cialis, is a medication that is commonly prescribed for erectile dysfunction but may be prescribed for benign prostatic hyperplasia as well to relax the muscles in the lower urinary tract and improve urinary symptoms. And then finasteride, which is brand named Proscar, can help prevent further growth of the prostate and, in some cases, can help shrink the size of the prostate as well.
If medications are not effective, there are a number of minimally invasive procedures, which are listed here on the screen, that can be used to treat BPH with moderate to severe symptoms. These procedures either destroy enlarged prostate tissue and/or widen the urethra to help improve urine flow. If you have severe symptoms and medications and minimally invasive procedures are not effective, then your provider may recommend surgery to treat your BPH. The most common type of surgery used to treat BPH is transurethral resection of the prostate or TURP surgery. During TURP surgery, the surgeon inserts an instrument called a resectoscope into the urethra and enlarged prostate tissue is removed with a wire loop. This type of surgery typically takes about one to two hours and often requires a one- to three-day stay at the hospital.
All right. That's it for this episode of Ask a Nurse. I hope it was helpful. If so, be sure to hit that like button. And if you haven't done so already, be sure to subscribe to our channel. Stay informed and stay well.
