Benign prostatic hyperplasia (BPH) is a common condition that affects many men as they age. While BPH can cause discomforting urological symptoms, it is manageable and treatable. Since the risk of developing BPH increases with age, it's essential for men to familiarize themselves with this condition and seek medical advice from a urologist if symptoms arise. 

In this article, we’ll explore the relationship between BPH and age, examine its causes and symptoms, and review the treatment options available to help you manage this condition. 

What is BPH (Benign Prostatic Hyperplasia)?

BPH refers to the non-cancerous enlargement of the prostate gland, a condition that becomes increasingly common as men grow older.

The prostate is a vital part of the male urinary and reproductive systems. It produces a fluid that combines with sperm to form semen and plays a role in ejaculation. The prostate also contains muscle fibers that regulate the flow of urine by contracting around the urethra, helping to maintain bladder control.

When the prostate becomes enlarged, it can interfere with urination or ejaculation. While the exact cause of BPH remains unclear, timely treatment is key to relieving symptoms and preventing the condition from worsening.

How Common is an Enlarged Prostate?

BPH is a prevalent condition, particularly in older men. Studies indicate that 29% to 33% of men over the age of 65 experience an enlarged prostate. While less common in younger men, BPH still affects approximately 5% to 6% of men between the ages of 40 and 64.

The severity of BPH symptoms can vary widely. Some men may experience mild, manageable symptoms, while others may remain asymptomatic. Regardless of the severity, support from a skilled urologist can help address symptoms and improve quality of life.

What Causes a Man’s Prostate to Enlarge?

The exact reasons for prostate enlargement over time are not fully understood. However, researchers have identified several potential benign prostatic hyperplasia causes and risk factors, including: 

• Hormonal changes: As men age, their levels of hormones like testosterone, estrogen, and dihydrotestosterone (DHT) fluctuate. These changes may contribute to prostate growth over time. 
• Family history: A family history of BPH or other prostate issues increases the likelihood of developing BPH and experiencing related symptoms. 

• Obesity: Obesity has been linked to a higher risk of BPH. While the precise connection remains unclear, some researchers suggest that obesity may lead to hormonal changes or added stress on the prostate, promoting growth.

If these risk factors apply to you, consider speaking with your urologist about BPH screening and available treatment options. Early detection can make a significant difference in managing symptoms effectively.

What is the Most Common Age for BPH to Develop?

The most common age for an enlarged prostate to develop in men is between their mid-40s and 60s, with the likelihood of an enlarged prostate increasing significantly as they age. Some experts even theorize that all men would eventually develop an enlarged prostate if they lived long enough.

Symptoms of BPH typically progress slowly, so you may not recognize the condition until years after it first develops.

Below is a breakdown of the prevalence of BPH across various age groups: 

Benign Prostatic Hyperplasia Risk Factors

Age is the most significant risk factor for BPH, as the likelihood of developing this condition increases considerably over time. However, there are other possible risk factors that you should be aware of. If these apply to you, a urologist can help you establish a proactive approach with regular screenings and personalized treatment options.  

Hormonal Changes and BPH

As you age, hormonal changes may stimulate the rapid growth and division of prostate cells, causing your prostate to enlarge. 

DHT, an androgen hormone critical to prostate development, has been strongly linked to prostate enlargement. Over time, DHT may promote the continuous growth of prostate cells, leading to BPH. 

Family History and Genetics

If your biological family members, such as your father or grandfather, have a history of BPH, your risk of developing the condition is higher. This risk is even greater if they developed BPH relatively early in adulthood. Knowing your family history and scheduling regular prostate checks can help you detect and manage BPH at an earlier stage.

Obesity

Obese men are more likely to develop BPH than men who maintain a healthy weight. If you are obese, working with your doctor to lose weight can help you reduce your risk of prostate and urinary issues. 

Lifestyle Factors

Your diet and exercise habits can also influence your risk of developing BPH. Diets high in meat and fat have been associated with a greater risk of prostate enlargement, while a diet rich in vegetables may help reduce that risk.

Regular physical activity can also help prevent and manage symptoms. Strengthening your pelvic floor and abdominal muscles may help alleviate urinary symptoms for those already experiencing BPH.

Symptoms of BPH and Their Impact on Quality of Life

While some men with BPH may not experience symptoms, most will encounter noticeable changes as the condition progresses. Common symptoms of BPH include:

• Frequent urination
• Weak or dribbling urine stream
• Difficulty starting or stopping urination
• Nocturia (waking up frequently to urinate)
• Discomfort while urinating
• Unusual urine odor or color
• Pain after ejaculation
• Urinary tract infections
• Presence of blood in urine

These symptoms can significantly disrupt daily life, particularly if untreated. Frequent urination, for instance, can interfere with work, hobbies, and physical activity. It may also cause sleep disturbances, leading to insufficient rest and subsequent physical and mental health issues.

Certain medications can also make BPH symptoms worse. These include diuretics, NSAID pain relievers, antihistamines, decongestants, and some types of antidepressants. 

If you have any symptoms of BPH, it’s important to consult with a specialist. At Golden State Urology, we use the International Prostate Symptom Score (IPSS) to measure the severity of BPH symptoms. This helps us provide an accurate diagnosis and select appropriate treatment options. 

When to See a Urologist for BPH Symptoms

If your BPH symptoms are causing discomfort or interfering with your quality of life, even in mild cases, seeking medical care is the first step in finding relief. A urologist can help you explore treatment options that will allow you to enjoy your life without interruptions or discomfort.

Left untreated, BPH may worsen and lead to complications such as urinary tract infections, bladder stones, or long-term kidney damage. These complications arise when the body can’t properly pass urine, intensifying symptoms.  

How is BPH Diagnosed?

Diagnosing benign prostatic hyperplasia (BPH) involves a comprehensive, step-by-step process conducted by a urologist:

1. Medical History and Symptom Assessment: The process begins with a review of your medical history and completing the International Prostate Symptom Score (IPSS) questionnaire to assess the severity of your symptoms.
2. Physical Examination: If symptoms suggest BPH, the urologist performs a physical exam. This typically includes a digital rectal exam (DRE), where a gloved finger is inserted into the rectum to evaluate the size and shape of the prostate for signs of enlargement.
3. Further Testing: Additional tests may be ordered to confirm the diagnosis, such as blood tests to check for prostate-specific antigen (PSA) levels or urine tests to rule out infections or other conditions.

By following this thorough diagnostic process, your urologist can accurately determine whether you have BPH and develop a tailored treatment plan to address your symptoms.

Treatment Options for BPH

If you receive a BPH diagnosis, don’t worry—there are many treatment options available to help relieve your symptoms so you can live more comfortably. Your urologist will work with you to help you select the treatment that is most appropriate for your symptoms, lifestyle, and preferences.

Active Surveillance for BPH

Active surveillance may be a practical approach for patients with mild symptoms that do not significantly impact daily life. This involves:

• Lifestyle Adjustments:
  • Reducing liquid intake, especially before bedtime, to prevent an overactive bladder.
  • Limiting alcohol and caffeine, which can irritate the bladder.
  • Maintaining a healthy weight through balanced nutrition and regular exercise.
  • Addressing underlying health issues that may influence weight or urinary health.
• Regular Monitoring: Routine check-ups with your urologist ensure that symptoms are monitored and treatment plans are adjusted as needed. Early detection and intervention can prevent the progression of symptoms and reduce the risk of complications. 

Active surveillance allows you to manage mild BPH symptoms effectively while minimizing the need for more invasive treatments. By making healthy lifestyle changes and staying proactive with regular check-ups, you can maintain your quality of life and prevent potential complications.

Medications for BPH

There are several medication options available for BPH. Here are some of the most common treatments and their role in managing urinary symptoms:

• Alpha Blockers: This is a class of drugs used to slow or stop cell communication. When used to treat BPH, they relax the muscle fibers in the prostate and bladder neck, which makes urination easier and more comfortable. 
• 5-Alpha Reductase Inhibitors (5ARIs): These drugs block the production of 5a-reductase inhibitors, which convert testosterone into DHT. This helps prevent DHT from causing further prostate enlargement. 
• Phosphodiesterase-5 Inhibitors: These inhibitors are popular treatments for erectile dysfunction but can also be helpful for managing BPH. This is because they increase blood flow to the area and improve prostate muscle tone, which results in better muscle control for the urinary system. 

Many patients benefit from using two or more medications to manage BPH. It’s also essential to stop taking medications that could make BPH symptoms worse, such as diuretics. Be sure to consult your healthcare provider to avoid potential drug interactions and report any side effects right away. 

Minimally Invasive Surgical Therapies (MIST) for BPH

If your BPH symptoms are moderate to severe, minimally invasive surgical therapies (MISTs) may be an effective option. These treatments involve surgical techniques that are far less invasive than traditional surgeries. These include: 

• UROLIFT® Treatment: This groundbreaking treatment places tiny implants through the urethra to lift and support prostate tissue. This relieves pressure on the bladder and urethra so you can urinate normally. 
• Transurethral Water Vapor Therapy: This treatment uses water vapor to shrink enlarged areas of the prostate. The vapor is delivered with an instrument inserted into the urethra and doesn’t require incisions or stitches.

MISTs are often preferred by patients for their shorter recovery times and greater comfort compared to traditional surgeries. However, they may not be suitable for individuals with more severe BPH cases.

Surgical Options for BPH

For severe BPH, surgery may be the most effective treatment, especially if medications or MISTs have not provided relief. Common surgical options include:

• Transurethral Resection of the Prostate (TURP): This procedure removes excess prostate tissue using a resectoscope and very small internal incisions to alleviate urinary symptoms. 
• Laser surgery: Utilizing holmium or other lasers, this procedure removes excess prostate tissue with precision, avoiding traditional incisions.
• Electrovaporization: A specialized laser vaporizes prostate tissue instead of cutting it, offering a less invasive alternative. 
• Robotic surgery: In some cases, surgeons can use robots to assist with prostate surgery, which can produce more precise results. 

Because these surgeries are more invasive than other BPH treatments, they will require downtime afterward for recovery. Many patients will need to use a Foley catheter during the initial healing phase to help with urination. This small tube drains urine from the bladder while the body recovers. 

Talk to a Specialist at Golden State Urology

If you’re experiencing symptoms of BPH or have concerns about your prostate health, schedule a consultation with the experts at Golden State Urology. Our highly skilled team specializes in diagnosing and treating BPH and other prostate conditions, using state-of-the-art technologies and personalized care plans to meet your unique needs.

At Golden State Urology, we offer advanced treatment options, including UROLIFT®, a minimally invasive procedure designed to relieve symptoms and improve your quality of life. Our commitment to innovation and compassionate care ensures you receive the best possible outcomes.

Take the first step toward better urological health—contact us today to schedule your appointment and learn more about how we can help you feel your best.