Enlarged Prostate (BPH)

As men age, their prostate gland grows larger. For some men, this can cause a number of urinary symptoms like an urgent need to urinate (especially at night), difficulty starting/stopping urinating, inability to completely empty the bladder and in some cases, sexual dysfunction.

This condition, called benign prostatic hyperplasia or BPH, is typically uncovered with a digital rectal examination during a doctor’s physical. In addition, a PSA test, MRI, or ultrasound may provide a more definitive diagnosis.

What causes BPH?

The prostate gland is located just below the bladder. As it grows larger, it can press against the urethra, the tube that carries urine out of the body. A growing prostate is thought to be the result of hormonal changes and aging, as well as other factors such as family history, being overweight, diet, and having diabetes or heart disease. It most commonly occurs in men over age 50 and affects most men by the time they reach 80. An enlarged prostate will not go away on its own; left untreated, symptoms will likely worsen and lead to other problems.

What are my treatment options?

Men with mild BPH symptoms can be treated with lifestyle changes, medication or supplements. Your doctor may also ask you to avoid taking certain medications like decongestants or certain antihistamines that can affect your prostate.

Those with more severe symptoms have many treatment options, including surgery. The most common surgery for an enlarged prostate is called transurethral resection of the prostate (TURP), in which a surgeon cuts away a portion of the prostate to make it smaller. However, this surgery has potential side effects that include infection, urinary issues, sexual dysfunction and retrograde ejaculation.

Some urologists now offer a less invasive procedure called UroLift®. This involves implanting metal clips that physically lift the urethra away from the prostate. While it can alleviate urinary symptoms, it does not address the root cause of the problem—the enlarged prostate. As a result, it has not been shown to improve sexual function in men who have the procedure.

A minimally invasive, outpatient procedure called prostate artery embolization (PAE) was approved by the FDA in 2018 and has become an excellent option for most men with BPH. It effectively shrinks the prostate, reducing or eliminating urinary symptoms. It is also shown to improve sexual performance. Take our quiz to see if you qualify for PAE.

International Prostate Symptom Score (I-PSS) Questionnaire

This field is for validation purposes and should be left unchanged.

In the past month:

1. Incomplete Emptying: How often have you had the sensation of not emptying your bladder?(Required)
2. Frequency: How often have you had to urinate less than every two hours?(Required)
3. Intermittency: How often have you found you stopped and started again several times when you urinated?(Required)
4. Urgency: How often have you found it difficult to postpone urination?(Required)
5. Weak Stream: How often have you had a weak urinary stream?(Required)
6. Straining: How often have you had to strain to start urination(Required)
7. Nocturia: How many times did you typically get up at night to urinate?(Required)