BPH (Enlarged Prostate)

What is it?

BPH stands for Benign Prostatic Hypertrophy...big words for such a small gland. The prostate is a walnut sized gland that sits at the base of the bladder in men. The prostate helps to control urination and also secretes a fluid along with the semen to help move them along the urethra when a man ejaculates. Generally starting in the forties and beyond, a man might be made more aware of his prostate because it gets larger as the male body ages. This has no impact on life expectancy, but can certainly affect one's quality of life if the size becomes an issue.

How do I know if I have it?

Because of the location of the prostate at the base of the bladder, an oversized gland can cause substantial symptoms. A man might suspect his prostate is enlarged due to symptoms such as: frequent urination, a weak urinary stream, delay or difficulty in starting urination, and of course the beloved dribbling of urine after urination is thought to be complete.

How can I get tested for it?

A simple and brief, albeit slightly invasive, exam in the office is done to assess for BPH and also as part of the annual prostate cancer screening for my male patients over forty years old. A digital rectal exam takes about a minute and gives an immediate assessment of the prostate. A controversial blood test called PSA is also sent, but is utilized more for prostate cancer screening and might not be helpful to diagnose BPH. Sometimes urine testing and an ultrasound of the prostate can be helpful as well.

How can it be treated?

There are a multitude of supplements such as saw palmetto and cranberry extract that can be used to help relieve symptoms. These are effective for some individuals, but not for many others. There are prescription medications that can relax the prostate muscle and therefore improve symptoms, and others that actually shrink the prostate size over time. I review symptoms, perform a physical exam and send blood tests as part of the evaluation before offering the best options for each patient.