Benign Prostate Hyperplasia (BPH)

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As men age, prostate problems, including benign prostate hyperplasia (BPH) and prostate cancer, can become more likely.

 

Houston Methodist doctors, nurses and staff are committed to offering the most advanced approaches to preventing, diagnosing and treating prostate problems like benign prostate hyperplasia. In fact, we were the first institution in the Texas Medical Center to offer GreenLight™XPS™ laser therapy  the most advanced enlarged prostate treatment available.

Symptoms of Benign Prostate Hyperplasia

The prostate is a walnut-shaped gland under a man’s bladder. The urethra, the tube that carries urine from the bladder out of the body, passes through the prostate to the penis. A growth spurt occurs in the urethra during puberty, but a second growth spurt can occur around age 50.
 
During this second growth spurt, an enlarged prostate can block urine flow through the urethra — similar to a clamp around a garden hose. This causes a condition known as enlarged prostate, or benign prostate hyperplasia (BPH). As the bladder struggles to pass urine through the blocked urethra, the bladder wall thickens, causing symptoms such as:
  • Increased urination frequency
  • Weak urine stream
  • Start-and-stop flow of urine
  • Incomplete emptying

 

Not all men with benign prostate hyperplasia experience symptoms.

Diagnosis of Benign Prostate Hyperplasia

If your doctor suspects you may have benign prostate hyperplasia (BPH), he or she may use one or more of the following tests to diagnose your condition, identify the cause and plan the best course of treatment:

 

Digital rectal exam (DRE)  typically part of an annual exam, but may be done between checkups if your doctor suspects a prostate problem. The doctor inserts a gloved, lubricated finger in the lower part of your rectum to feel the prostate and check for enlargement.

Urine flow study  measures urine flow speed as you urinate into a special device. Slow speed could indicate benign prostate hyperplasia.

Cystoscopy  more accurately checks prostate size and collects additional information about obstruction. After giving you a local anesthetic, your doctor will insert a small tube called a cystoscope through your urethra. The tube contains a lens and light, which allows your doctor to see inside the urethra and bladder.

Treatment of Benign Prostate Hyperplasia

If you have benign prostate hyperplasia (BPH) and it's causing symptoms, your doctor may recommend lifestyle changes, medications or a medical procedure — depending on the severity of your symptoms.

 

A mild case of benign prostate hyperplasia may require lifestyle changes, including:

  • Urinating as soon as you first feel the urge
  • Urinating regularly throughout the day, whether or not you have an urge
  • Avoiding alcohol and caffeine
  • Spreading fluid intake throughout the day and limiting fluids at night
  • Avoiding decongestants and antihistamines
  • Reducing stress

 

In some cases, your doctor may recommend medications that can help reduce the symptoms of benign prostate hyperplasia. Medicines such as finasteride and dutasteride can inhibit production of hormones involved with prostate enlargement, preventing further prostate growth. In addition, alpha 1 blockers such as terazosin, doxazosin, tamsulosin and alfuzosin can relax your prostate and bladder muscles to improve urination.

 

Antibiotics also may be prescribed to treat chronic prostatitis (prostate inflammation) — another prostate problem that sometimes accompanies benign prostate hyperplasia.

 

If medications don't relieve your symptoms, your doctor may recommend surgical options to remove obstructing prostate tissue. Until recently, the only surgical option was transurethral resection of the prostate (TURP), during which a resectoscope and loop, similar to a hot wire, were used to remove enlarged tissue. Though effective, TURP often requires a 24- to 48-hour hospital stay and a longer catheterization period.

 

Now, laser surgery is a more favorable treatment option for benign prostate hyperplasia. GreenLight™XPS™ laser therapy transmits energy through a small fiber inserted into the urethra using a cystoscope. The laser superheats targeted prostate tissue and vaporizes it — creating a channel for urine to flow more freely. This procedure is minimally invasive and quicker than TURP, meaning many men can go home without a catheter the same day. In addition, most men see immediate urine flow improvement.

 

In addition, our urology specialists offer Rezūm Water Vapor Therapy, a minimally invasive, in-office procedure that uses the natural energy stored in steam to effectively treat benign prostate hyperplasia. With this treatment, there are no incisions, no general anesthesia is needed, sexual function is preserved and most men return to regular activities within a few days.

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