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BPH – Signs, Symptoms, and Cause

Benign Prostatic Hyperplasia (BPH) – Signs, Symptoms, and Causes

Do you ever have a hard time urinating? This can be a telltale sign of a larger health problem behind the scenes called Benign Prostatic Hyperplasia.

Benign Prostatic Hyperplasia (BPH) refers to the condition in which a man’s prostate gland becomes enlarged, which can result in the prostate blocking the flow of urine from the bladder. BPH, also called Prostate Gland Enlargement, is a condition common among older men.

In addition to difficulty urinating, BPH can also cause other bladder, urinary tract and kidney issues.

Signs and Symptoms

While the symptoms of BPH can vary from case to case, these symptoms can worsen over time causing frustration if not addressed. Some of the common symptoms of BPH may include, but are not limited to:

  • Difficulty starting urination
  • Increased urination frequency at night
  • Urgent or frequent need to urinate
  • The inability to completely empty the bladder
  • Dribbling at the end of urination
  • Weak urine stream or a stream that stops and starts

Other less common symptoms may include blood in the urine, the inability to urinate, or a urinary tract infection.

Some may assume that the size of the prostate may determine the severity of the symptoms of BPH, but that isn’t necessarily true. Some men with only slightly enlarged prostates suffer from debilitating symptoms, while other men with severely enlarged prostates show only minor symptoms. It’s also important to note that some symptoms have been known to improve over time or eventually level out.

If you’re experiencing urinary symptoms, there are a few other things that could be causing the issues, but your doctor can make that determination. Some of these causes could be: a urinary tract infection (or UTI), bladder or kidney stones, narrowing of the urethra, scarring in the bladder neck (result of previous surgery), cancer of the prostate or bladder, inflammation of the prostate, or problems with the nerves that control the bladder.

Seeking Medical Help

You may be asking “When should I see a doctor?” The answer is as soon as you begin to notice the symptoms are present, even if they aren’t really bothering you. If left untreated, urinary problems could lead to a blockage of the urinary tract or other serious medical problems.

Causes: The Great Unknown… Kind Of

The prostate gland is located under your bladder. The tube that drains urine from the bladder out of your penis passes directly through the center of your prostate. As the prostate beings to enlarges, the flow of urine can be partially blocked. Now, most men have continued prostate growth throughout their lives, and in many men, that continued growth can cause the urinary symptoms.

It’s not entirely clear how or why the prostate begins to enlarge, but there is certainly a connection to the breakdown of testosterone receptors in the prostate.


While there are many different complications from BPH, most men will not experience these, but kidney damage and acute urinary retention can be considered serious threats to your health. Some of the potential complications include: kidney damage, bladder stones, UTIs, bladder damage, or urinary retention.

Treatment Options

Option #1: Observation – This might be the best option if symptoms are mild and the exam and other work up is not worrisome. Dietary modifications like limiting caffeine can be helpful. The addition of herbal supplements like saw palmetto can also be considered.

Option #2: Medication – This is a common option for a lot of men and is very effective in many cases. In general, medications are aimed at relaxing the prostate and bladder neck or at shrinking the prostate over time to improve symptoms.  Most are tolerated well but sometimes medication side effects, cost, interactions, etc. can cause these to be less desirable.

Option #3: Surgery – Most commonly in this category we think of the TURP (TransUrethral Resection of the Prostate) to relieve obstruction and allow for better flow of urine and symptom relief. If the prostate is very large, resection of the inner portion of the prostate is completed from within the abdomen using robotic assisted laparoscopic techniques as well. Again, these are very good options for a lot of men but may carry potential side effects and temporary catheterization that men would like to avoid if possible.  Also, as this is a disease that is more common with increasing age, some men may not be very good surgical candidates in some instances.

Now, more options are becoming available to bridge the gap between medications and traditional surgery for men with moderately enlarged prostates.

Rezum is an office-based procedure in which steam is injected through the wall of the prostate from within the urethra. This results in the eventual regression of the obstructing tissue within the prostatic urethra and subsequent improvement in voiding symptoms.

Urology Centers of Alabama is now offering a new procedure called The Urolift System which can be performed in the office or in an operative setting to simply reposition the obstructing tissue. This is accomplished using small implants into the prostate itself to hold the lobes of the prostate out of the way. It shows a rapid improvement in symptoms with minimal downtime and often does not require the use of a catheter after the procedure. It also has the unique advantage of having no effect on erectile dysfunction and ejaculation, as there is no cautery, heat or destruction of native tissue, which could affect the nerves involved in sexual function.

 If you believe that you or a loved one are experiencing any of these symptoms or the beginning stages of BPH, Urology Centers of Alabama and its team of knowledgeable physicians can help determine the correct plan of action to correct this issue.

If you believe that you or a loved one are experiencing any of these symptoms or the beginning stages of BPH, Urology Centers of Alabama and its team of knowledgeable physicians can help determine the correct plan of action to correct this issue. Click here to request an appointment.

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