Benign prostatic hyperplasia (BPH), or "enlarged prostate," is a condition that can cause many of the same symptoms as prostate cancer.
What should you know about this important condition?
What Is BPH?
BPH is a non-cancerous increase in the size and number of cells that make up the prostate.
Who Gets BPH?
BPH is almost always found in older men. Since women do not have a prostate, they cannot get BPH. And young men almost never experience symptoms of an enlarged prostate. The prostate enlarges over the course of many years of exposure to male hormones, and young men typically have not had enough years of exposure for symptoms to show up.
What Causes BPH?
During puberty, the prostate goes through a phase of very rapid enlargement, but this levels off once puberty is completed. Starting in mid-life, the prostate begins growing again, but very slowly this time.
It is thought that these periods of growth result from increased levels of male hormones such as testosterone. Testosterone is produced throughout a man’s life and, subsequently, the prostate grows throughout a man’s life.
Due to the slow progression of this growth, most men do not notice any symptoms of BPH until they are older and the prostate has grown to such a size that it impinges on the outflow of urine from the bladder.
What Symptoms Does BPH Cause?
Due to the location of the prostate, BPH causes a number of urinary symptoms. The prostate is located just below where the bladder empties into the urethra (which is a thin tube that carries urine from the bladder, through the penis, to outside the body). As the prostate enlarges, it impinges the flow of urine through the urethra.
The most common symptoms are:
- Frequency - urinating much more often than normal.
- Urgency - having a sensation that you need to urinate immediately.
- Nocturia - getting up to urinate multiple times during the night.
- Hesitancy - difficulty starting the urine stream.
These symptoms can be identical to those experienced by men with prostate cancer. There is no way to tell if your symptoms are due to BPH or prostate cancer, so it is essential to visit your physician if you develop any of these symptoms.
How Do I Know That I Don’t Have Prostate Cancer?
If you have the symptoms listed above, you should see your physician. There is no way to tell whether you have BPH or a more serious problem like prostate cancer based on symptoms alone.
To diagnose BPH, prostate cancer must first be ruled out. To rule out prostate cancer, you need to undergo a digital rectal examination (DRE) and a prostate specific antigen (PSA) blood test at the minimum. These tests are used to diagnose prostate cancer and, if both are negative, then your chances of having prostate cancer are very low.
Barry MJ, Cockett AT, Holtgrewe HL, et al. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. The Journal of Urology.Aug 1993;150(2 Pt 1):351-8.
Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. The Journal of Urology. Sep 1984;132(3):474-9.