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Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH), also referred to as enlarged prostate, occurs when a prostate is enlarged, but does not have cancer. About 50 percent of men aged 50 years or older in the United States have an enlarged prostate, but many of those men are not diagnosed or treated. The prevalence of BPH increases with age such that most men will suffer from symptoms at some point in their lifetime. Faculty urologists at Indiana University School of Medicine are dedicated to providing highly specialized, state-of-the-art treatments for BPH. Indiana University School of Medicine Department of Urology is one of the few departments in the nation to offer Holmium Laser Enucleation of the Prostate (HoLEP) for the treatment of BPH.
An enlarged prostate is the most common prostate condition in men. Symptoms can include straining to urinate, a weak urine stream, urinary retention (or inability to urinate) and frequent urination, among others. It is also a major cause of urinary symptoms in men over 40 years old. These symptoms can worsen over time if BPH goes untreated, but an enlarged prostate does not increase a man’s risk of developing prostate cancer. Patients experiencing BPH symptoms may be asked to complete a symptom assessment, like the one from the American Urological Association, to determine the severity of their symptoms.
BPH can be diagnosed by measuring a patient’s symptom score through a validated questionnaire. The physician may also request a specialized urine flow test called a uroflow, which measures the rate at which urine exists the urethra. They may also request an ultrasound of the bladder after urination to assess the amount of urine remaining also known as a post void residual. A prostate specific antigen (PSA) level may be assessed through a blood test if the physician feels further evaluation is warranted. An elevated PSA level may lead a physician to obtain a biopsy, to ensure prostate cancer is not the cause of the urinary symptoms. Other tests the physician may order if necessary are a cystoscopy, which is a scope inserted through the urethra to look at the interior of the prostate and bladder, or a CT scan or an ultrasound of the prostate to assess the size.
There are several treatment options for BPH, depending on the severity of symptoms. A physician may decide to not take action right away, but instead watch the prostate closely over time to see how the condition progresses. There are also medical therapy options and surgical options, such as transurethral resection of the prostate (TURP), laser ablation of the prostate or holmium laser enucleation of the prostate (HoLEP).