Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, is when your prostate gland grows larger than normal but is not cancerous. It can press against your bladder or urethra, causing bladder and urinary problems.

Common among older men, BPH affects around 50% of men ages 50 to 60 and up to 90% of men over 80. It is not usually serious, but the condition can cause pain and negatively impact your quality of life.

The experienced urology specialists at Beaufort Memorial understand that BPH can be a sensitive issue for men. At our clinics in Beaufort and Okatie, we offer compassionate, personalized care for BPH with many surgical and nonsurgical treatment options designed to address symptoms with as few side effects as possible.

Find relief from your BPH symptoms. Call 843-524-7607 to request an appointment with Beaufort Memorial Urology Specialists in Beaufort or Okatie.

Understanding BPH

Your prostate gland is about the size of a walnut and located between your penis and bladder. With BPH, the prostate grows so large that it puts pressure on the urethra and causes the bladder wall to thicken. As a result, the bladder may become weak and unable to empty. Urine remains in the bladder, causing many of the symptoms associated with the condition.

The reason the prostate becomes enlarged remains unclear, although medical experts suspect hormone changes play a role.

As you age, the balance of testosterone (the male sex hormone) and estrogen (the female sex hormone) in your body changes. Men’s bodies produce both sex hormones, but with age, the testes produce less testosterone, while estrogen production stays the same. This imbalance could trigger the growth of prostate cells, which may lead to an enlarged prostate.

Another theory focuses on the hormone dihydrotestosterone (DHT), which supports prostate development and may stimulate prostate cell growth. As testosterone levels decline with age, DHT continues to build up in the body, potentially causing an enlarged prostate.

While it’s clear that the risk of BPH rises with age, other factors can make you more prone to developing the condition. Those factors include:

• Being overweight or obese
• Having a family history of BPH
• Having erectile dysfunction
• Having Type 2 diabetes, heart disease or a circulatory condition
• Leading a sedentary lifestyle

Symptoms of BPH

BPH can cause symptoms including:

• A weak or slow urine stream
• Changes in the color or smell of urine
• Difficulty starting to urinate
• Dribbling after urinating
• Feeling that you cannot empty your bladder completely
• Frequent or urgent need to urinate
• Pain after ejaculation
• Pain during urination
• Urinary incontinence or being unable to control urination
• Waking in the night needing to urinate

Symptoms can range from mild to severe. Even mild symptoms can benefit from a visit with your provider. Some symptoms of BPH could occur due to other health problems, and an accurate diagnosis of BPH or another prostate issue allows you to get the most appropriate treatment.

In addition, BPH can lead to urinary tract infections (UTIs), bladder stones and bladder damage.

Diagnosing BPH

If you experience issues urinating or are concerned about your prostate, don’t feel embarrassed to talk to your primary care provider or a urologist.

Your provider will perform a physical exam and discuss your symptoms, medical history and family medical history. Then, you may need tests to rule out other conditions or confirm a diagnosis of BPH.

Physical Exam

During your initial appointment, your provider will ask about previous health conditions, including UTIs, and whether you take medications. They may also ask you how much fluid you drink and whether you drink caffeine or alcohol.

Your provider may also perform a digital rectal exam (DRE). They will insert a lubricated, gloved finger into your rectum to feel your prostate. DREs can be mildly uncomfortable.

Finally, your provider may examine your urethra to check for discharge, feel for tenderness in your scrotum or see if you have any enlarged lymph nodes in your groin area.

Lab and Imaging Tests

Based on the results of your physical exam, your provider may order one or more of the following tests to confirm a diagnosis:

• Benign prostatic hyperplasia ultrasound, or transrectal ultrasound: A probe inserted into your rectum sends high-energy sound waves that form an image of your prostate.
• Biopsy: Your urologist takes a tissue sample from your prostate and sends it to a lab, where it is analyzed for abnormal cells or cancer. Your biopsy may be performed with ultrasound or MRI guidance and is usually done while you’re sedated.
• Cystoscopy: Your urologist uses an instrument called a cystoscope to examine your urethra and bladder. These tests are also done under a sedative or anesthesia.
• Prostate-specific antigen (PSA) blood test: High levels of PSA, a protein produced by the prostate, can indicate an enlarged prostate. PSA tests can also screen for prostate cancer, so if you have high levels, your provider may order additional tests to rule out cancer. However, BPH does not increase the risk of prostate cancer.
• Urine tests, or urinalysis: A urine sample will be analyzed for blood or signs of infection.
• Urodynamic tests: These tests check how well your bladder, sphincters and urethra work together to store and release urine. They can determine if your bladder is not emptying completely or if your urethra is blocked.

BPH Treatments

The urology specialists at Beaufort Memorial offer many effective treatments for BPH. They’ll review all your options and help you weigh the pros and cons of each so you can decide on the treatment that works for you and your lifestyle.

Your urologist may recommend nonsurgical treatments or a minimally invasive procedure for BPH. Options include:

• Active surveillance, a type of regular monitoring
• Laser ablation, which destroys prostate tissue
• Lifestyle changes that address mild BPH symptoms
• Pelvic floor physical therapy, which strengthens the muscles supporting the bladder and other pelvic organs
• Prescription medications that relax or shrink the prostate and address urinary issues
• Transurethral resection of the prostate, a nonsurgical procedure that uses lasers or an electric current to remove excess prostate tissue
• UroLift™, a minimally invasive procedure to lift the prostate and prevent it from blocking the urethra

Comprehensive Support for Men with Prostate Issues

The urology specialists at Beaufort Memorial are dedicated to providing patients with personalized care for BPH. Our thorough diagnostics and minimally invasive treatment options allow effective symptom relief and faster recovery times. We’ll also work with you on lifestyle changes you can make to prevent BPH before the condition occurs.