Benign Prostatic Hyperplasia (BHP)
Benign prostatic hyperplasia (BPH), better known as an enlarged prostate gland, is one of the most common urological conditions among men, with the incidence increasing with age. Approximately 70% of men between the ages of 60 and 69 are affected, with the prevalence rising to 80% over the age of 70.
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On this page
- What Is Benign Prostatic Hyperplasia (BPH)?
- What Are the Symptoms of Benign Prostatic Hyperplasia (BPH)?
- How Do You Diagnose Benign Prostatic Hyperplasia (BPH)?
- How Do You Treat Benign Prostatic Hyperplasia (BPH)?
What Is Benign Prostatic Hyperplasia (BPH)?
The prostate gland is an organ the size of a walnut placed under the base of the bladder, anterior to the rectum; It produces part of the seminal fluid that carries sperm. When it swells too much, it can restrict urinary flow.
BPH is benign and does not evolve into cancer. It can be bothersome and lead to urinary tract infections. Other potential complications include kidney failure, bladder stones and blockage of urinary flow.
Risk factors
Although the exact cause of BPH is still unknown, some hormonal changes are thought to be decisive. Potentially, it can affect all men, but they are more likely to develop it if they have these risk factors:
- Age – More common after the age of 40.
- Family history – Having relatives with BPH increases the likelihood of developing it.
- Cardiovascular diseases – Some heart problems are associated with a higher risk.
- Type 2 diabetes – Linked to chronic inflammation that may promote BPH.
- Obesity – Overweight can affect hormone levels and promote prostate enlargement.
- Sedentary lifestyle – Lack of physical activity is a predisposing factor.
Adopting a healthy lifestyle can help reduce the risk and improve prostate health.
What Are the Signs and Symptoms of Benign Prostatic Hyperplasia (BPH)?
Some men have BPH but never develop symptoms because their urinary flow is not blocked. Others suffer from one or more of the following symptoms:
- Weak or slow urinary flow.
- Drip at the end of urination.
- Inability to completely empty the bladder.
- Incontinence or accidental loss of urine.
- Pain when urinating.
- Frequent urination, especially at night.
- A strong and sudden urge to urinate.
- Difficulty starting urination, with the need to strain.
If these symptoms occur or worsen over time, it is important to consult a doctor for an evaluation.
How Do You Diagnose Benign Prostatic Hyperplasia (BPH)?
After analyzing the patient's medical history, the doctor performs a physical examination to rule out abnormalities of the kidneys or bladder. A rectal exam will help your doctor determine the size of your prostate.
Other tests may include:
- Blood tests – to monitor any abnormalities.
- Pre and post-prostate massage examination – useful for assessing the presence of inflammation or infections.
- Measurement of residual urine after voiding – to check if the bladder empties completely.
- Ultrasound – for a detailed analysis of the prostate and bladder.
- Urine analysis – to exclude infections or other urinary conditions.
- Uroflowmetry – to assess the strength and speed of the urinary flow.
Early diagnosis allows for better management of symptoms and the selection of the most appropriate treatment.
How Do You Treat Benign Prostatic Hyperplasia (BPH)?
At UPMC, our experts are experienced in minimally invasive treatments tailored to prostate size, patient age, and ejaculation preservation techniques. Treatment options include:
- Rezum – The treatment is performed under local anesthesia. Through a small tube inserted into the urethra, steam is injected inside the prostate to reduce prostate tissue and the size of the gland.
- HoLEP Laser – Holmium laser enucleation of the prostate (HoLEP) is an advanced surgical technique for the treatment of benign prostatic hyperplasia, recognized and recommended by major urologic guidelines. It represents an effective alternative to endoscopic treatment. It also allows treatment of bulky prostates, which in the past would have required open surgery.
- ThuLEP Laser –Thulium Laser Enucleation of the Prostate (ThuLEP) is a minimally invasive technique for prostate resection that replicates the results of open surgery while minimizing bleeding and allowing patient discharge within 1-2 days.
- Robotic-assisted prostate adenomectomy (RARP) – Advanced surgical technique that removes the prostate and seminal vesicles, restoring the continuity of the urinary tract through robot-assisted reconstruction. In some cases, the removal of regional lymph nodes may also be necessary.
Reviewed March 2025.