Patient Resources

  • Benign Prostatic Hyperplasia or BPH

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia––also called BPH––is a condition in men in which the prostate gland is enlarged. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction. The prostate is a walnut-shaped gland found only in males. . The gland surrounds the urethra at the neck of the bladder

As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. This may in-turn lead to inability to empty the bladder completely causing urinary retention.

Causes of BPH & People at risk

The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Some researchers believe factors related to aging may cause BPH.

Men with the following factors are more likely to develop benign prostatic hyperplasia:

  • age 40 years and older
  • family history of benign prostatic hyperplasia
  • medical conditions such as obesity, heart and circulatory disease, and type 2 diabetes
  • lack of physical exercise
  • erectile dysfunction

Symptoms of Benign Prostatic Hyperplasia

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include

  • urinary frequency—urination more frequently each day
  • urinary urgency—the inability to delay urination
  • Hesitancy- trouble starting a urine stream
  • A weak or an interrupted urine stream
  • dribbling at the end of urination
  • nocturia—frequent urination during periods of sleep.
  • urinary retention – inability to pass urine.
  • urinary incontinence—the accidental loss of urine
  • Pain after ejaculation or during urination
  • Urine that has an unusual color or smell

Complications of Benign Prostatic Hyperplasia

The complications of benign prostatic hyperplasia may include

  • acute urinary retention
  • chronic, or long lasting, urinary retention
  • blood in the urine
  • urinary tract infections (UTIs)
  • bladder damage
  • kidney damage
  • bladder stones

Medical Help and Evaluation

A person may have urinary symptoms unrelated to benign prostatic hyperplasia that are caused by bladder problems, UTIs, or prostatitis––inflammation of the prostate.

Men with symptoms of benign prostatic hyperplasia should see an Urologist.

An Urologist diagnoses benign prostatic hyperplasia based on

  • a personal and family medical history
  • a physical exam
  • medical tests

An urologist uses medical tests to help diagnose lower urinary tract problems related to benign prostatic hyperplasia and recommend treatment. Medical tests may include

  • Urinalysis
  • a prostate-specific antigen (PSA) blood test
  • Uroflowmetry
  • Ultrasound of KUB region
  • Prostate biopsy
  • cystoscopy
  • Urodynamic tests

Treatment for BPH

Treatment options for benign prostatic hyperplasia may include

  • lifestyle changes
  • medications
  • minimally invasive procedures
  • surgery

Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist may recommend one of the treatment modalities.

Prevention and Dietary Habits

Researchers have not found a way to prevent benign prostatic hyperplasia. Men can get early treatment and minimize benign prostatic hyperplasia effects by recognizing lower urinary tract symptoms and identifying an enlarged prostate.

  • Treatment for Kidney Stones

Kidney stones are treated based on their size, location, and what type they are.

Small kidney stones can pass through your urinary tract without treatment. If you’re able to pass a kidney stone, your doctor may ask you to catch the kidney stone in a special container and send it for analysis.  You may be advised to drink plenty of liquids in such situation.

Larger kidney stones or kidney stones that block your urinary tract or cause great pain may need urgent treatment. If you are vomiting and dehydrated, you may be admitted in the hospital to receive fluids through an IV line.

Silent Kidney stones can also lead to damage to your kidneys.

Kidney stone removal

Urologist can remove the kidney stone or break it into small pieces with the following treatments:

A. Shock wave lithotripsy. The doctor may advise shock wave lithotripsy to blast the kidney stone into small pieces. The smaller pieces of the kidney stone then pass through your urinary tract. This is essentially an outpatient procedure without any surgical intervention.

B. Cystoscopy and ureteroscopy. During cystoscopy, the Urologist uses a cystoscope to look inside the urethra and bladder to find a stone in your urethra or bladder. During ureteroscopy, the doctor uses a ureteroscope to look inside at the lining of the ureters and kidneys. The doctor inserts the cystoscope or ureteroscope through the urethra of the patient. Once the stone is found, the doctor can remove it or break it into smaller pieces. The doctor performs these procedures in the hospital under anesthesia. You can typically go home the same or next day.

C. Percutaneous nephrolithotomy. The Urologist uses a Nephroscope, to locate and remove the kidney stone. The doctor inserts it directly into your kidney through a small cut made in your back. It is performed in a hospital under anesthesia. You may have to stay in the hospital usually for 2 to 3 days after the procedure. This duration may vary from case to case basis.

After these procedures, sometimes the urologist may leave a thin flexible tube, called a D J stent, in your urinary tract to help urine flow or a stone to pass. Once the kidney stone is removed, your doctor sends the kidney stone or its pieces to a lab to find out what type it is. You are more likely to form stones if you don’t make enough urine each day or have a problem with high mineral levels.

How can I prevent kidney stones?

To help prevent future kidney stones, you also need to know what caused your previous kidney stones. Once you know what type of kidney stone you had, your Urologist may suggest you make changes to your eating, diet, and nutrition to prevent future kidney stones.

A. Drinking liquids

In most cases, drinking enough liquids each day is the best way to help prevent most types of kidney stones. Drinking enough liquids keeps your urine diluted and helps flush away minerals that might form stones.

Though water is best, other liquids such as citrus drinks may also help prevent kidney stones. Some studies show that citrus drinks and juices containing citrate that helps in preventing crystals from turning into stones.

Unless you are suffering from kidney failure, you should drink six to eight glasses of water a day. Talk with your Urologist if you can’t drink the recommended amount due to other health problems, such as urinary incontinenceurinary frequency, or kidney failure.

The amount of liquid you need to drink depends upon both, your local weather and your activity level. In hot weather conditions, you may need more liquid to replace the fluid you lose through sweat.

B. Medicines

If you have had a kidney stone, Urologist also may prescribe medicines to prevent future kidney stones. Depending on the type of kidney stone you had and what type of medicine the health care professional prescribes, you may have to take the medicine for a few weeks, several months, or longer.

Hyperparathyroidism surgery

People with hyperparathyroidism, a condition that results in too much calcium in the blood, sometimes develop calcium stones. This condition is usually diagnosed by an Endocrinologist. Treatment for hyperparathyroidism may include surgery to remove the abnormal parathyroid gland.