Benign Prostatic Hyperplasia (BPH)

What is it?

Several things never stop growing until they die –trees, reptiles, the hair in your ears and your prostate. This walnut-sized gland is located in front of the rectum and just below the bladder. It wraps around the tube that drains your bladder (the urethra). Your doctor checks your prostate whenever he performs a digital rectal exam or DRE. Your prostate is important because it makes seminal fluid that mixes with sperm. This is released during an orgasm. Only men have a prostate gland; women have a uterus instead. Both the prostate and the uterus begin as the same tissue. It is your male hormones that turn it into a prostate.

Between the ages of 20 and 45, the prostate gland doesn’t grow much, but after that there’s no stopping it. Symptoms of this continuing growth don’t usually show up before age 60, but studies have shown that at least 90% of men past the age of 70 may have prostatism or benign prostatic hyperplasia (BPH).

How bad is it?

As its name implies, it is “benign,” which means that it is not cancerous –prostatic cancer is another disease. But it can still cause trouble when it tightens its grip on your urethra.

What causes it?

Male hormones. They are responsible for the growth of the prostate; it’s part of your manhood. The prostate makes its own brand of hormone from the testosterone released by your testicles.

How do I know I have it?

The main symptom of BPH is a decrease in the flow of urine. The classic question your doctor will ask you is: “Can you write your name in the sand (using your pee)?” If you answer no, you likely have BPH. If you answer, “Only my initials,” you are probably on your way. Other symptoms of BPH include:

  • hesitation in starting your urine flow
  • dribbling after you empty as much as you can get out
  • feeling a great urgency to urinate (This is also a symptom of a urine infection.)
  • urinating many times during the night (This can also be a symptom of heart failure.)
  • feeling as if all the urine hasn’t all come out.

Rarely the prostate will grow in such a way as to impinge upon the rectum and cause constipation.

Acute urinary retention

Once in awhile, men, usually elderly, with mild symptoms of BPH will suddenly be unable to urinate at all. This condition is known as acute urinary retention (AUR) and can be the result of a prescription medicine that weakens the bladder or an infection of the prostate (prostatitis) that makes it swell and pinch off what’s left of the passageway. Relief should be prompt, so the urine doesn’t continue to accumulate, stretch the bladder, and perhaps even back up into the kidneys, causing them to fail. AUR is usually treated by carefully inserting a tube, called a catheter, through the penis or directly through the belly using a large needle. There it will remain until the natural passage can be opened up, usually by surgery.

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