A common problem for older men, benign prostatic hyperplasia (BPH) is a noncancerous proliferation of cells in the prostate. The prostate, a walnut-sized gland below the bladder and in front of the rectum, is important in sexual function, providing much of the seminal fluid that carries sperm. The gland grows slowly as men age, pressing on the bladder and part of the urethra.
In some men, this enlargement begins to cause symptoms by mid-life. Half of all men have trouble urinating by age 60, and the rate rises to 9 out of 10 by age 70. By age 80, about 20 to 30 percent of men require some form of treatment for BPH.
You have more frequent urges to urinate with BPH, but then you get a hesitant, weak stream or dribbling. You may have trouble getting a solid night’s sleep and may dread being more than a few steps from a toilet, waiting in line for the men’s room or seeing the “fasten seat belt” sign illuminated in an airplane. A few men develop urinary tract infections or “acute urinary retention,” an inability to urinate at all that requires urgent medical care.
BPH is called “benign” because the enlargement is not harmful in itself. It is not cancer, nor does it lead to cancer (“hyperplasia” simply means an increased number of normal cells). Of course, BPH may not seem so benign if you have it. But at least it does not affect sexual function.
Why BPH occurs: No one knows what causes prostate enlargement. Some studies have pointed to a connection with being overweight. In fact, losing weight if you are overweight may lessen symptoms. Some studies suggest that consuming lots of fruits and vegetables and minimizing red meat intake may reduce the risk. One study found that aspirin and other nonsteroidal anti-inflammatory drugs may also reduce the risk of BPH, but this has yet to be confirmed—and other findings contradict this idea. The normal drop in testosterone levels that comes with aging may have something to do with BPH, but this does not mean that testosterone supplementation will help. Indeed, it might make matters worse.
If you have symptoms, see your doctor. A medical evaluation can determine whether it is BPH or some other condition. No biopsy is needed to diagnose it. Lifestyle strategies and/or medical options can help you manage the condition.