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Benign prostatic hyperplasia
Other Resources UpToDate PubMed

Benign prostatic hyperplasia

Contributors: Amirah Khan MD, Pamela L. Sloan MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Benign prostatic hypertrophy (BPH) is a noncancerous enlargement of the prostate gland due to hypertrophic glands, causing blockage of urine flow. This disorder is common in men aged older than 50 years, tends to be slowly progressing, and leads to significant disability. It is characterized by urinary dysfunction (frequency, urgency, nocturia, incomplete emptying, and incontinence) and disruption in urinary stream (hesitancy, intermittent flow, dribbling of urine). This spectrum of symptoms is categorized as lower urinary tract symptoms (LUTS). Severity of symptoms can be determined by use of the American Urological Association Symptom Index, which can help guide management. Potential risk factors for the development of BPH include elevated protein-specific antigen (PSA) and obesity. BPH is not a known risk factor for prostate cancer.

Management includes modifications in routine (limiting fluids at bedtime, caffeine intake, and diuretics) and medications. BPH can cause acute urinary retention, which requires catheterization. Patients with poor results may seek surgical treatment such as prostatic urethral lift, transurethral resection of the prostate, transurethral incision of the prostate, or prostate laser surgery.

Codes

ICD10CM:
N40.0 – Enlarged prostate without lower urinary tract symptoms

SNOMEDCT:
266569009 – Benign Prostatic Hyperplasia

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Differential Diagnosis & Pitfalls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:01/03/2019
Last Updated:01/10/2021
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Patient Information for Benign prostatic hyperplasia
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Contributors: Medical staff writer

Overview

Benign prostatic hyperplasia (BPH) is also called enlarged prostate. The walnut-sized prostate gland is located between the urinary bladder and the penis, surrounding the urinary tube, or urethra. As the prostate gland slowly gets bigger with age, it can cause problems with urination. An enlarged prostate is not cancerous.

Who’s At Risk

Most men develop an enlarged prostate gland as they grow older. However, not all men experience symptoms or require treatment. One study showed that about half of men in their 50s had an enlarged prostate. More than 80% of men over the age of 80 may have benign prostatic hyperplasia.

The cause is uncertain and may be related to many factors. It may run in families. Enlarged prostate is more likely in men who are overweight, have diabetes or heart disease, or use certain medications.

Signs & Symptoms

Urinary problems are the most common symptoms of an enlarged prostate. These include:
  • Trouble starting urination
  • A disrupted flow of urine
  • Incomplete urination
  • Frequent urge to urinate
  • Loss of control of urination or urinary leaking
You also might experience dripping following urination and frequent nighttime urination.

Complications may include urinary tract infections, blood in the urine, or the inability to urinate. An inability to urinate is a medical emergency.

Self-Care Guidelines

  • Limit alcohol and caffeine
  • Limit drinking fluids near bedtime (or when away from restrooms)
  • Avoid certain medications, such as decongestants and antihistamines, that slow urination
  • Manage weight and stay active
  • Use bladder training techniques
  • Use absorbent incontinence products for men

When to Seek Medical Care

Contact your health care provider if you have problems with urination to rule out more serious or malignant causes.

If complications arise, such as bloody urine or an inability to urinate, get medical care immediately.

Treatments

Your doctor may refer you to a urinary specialist (urologist). You will be given options to deal with the problematic symptoms of benign prostatic hyperplasia. These may include medication and/or surgery. Your doctor or urologist can answer your questions about the advantages and disadvantages of each treatment.
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Benign prostatic hyperplasia
Imaging Studies image of Benign prostatic hyperplasia - imageId=6843804. Click to open in gallery.  caption: '<span>Axial CT image demonstrates enlarged prostate in this patient with known BPH. </span>'
Axial CT image demonstrates enlarged prostate in this patient with known BPH.
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