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Benign Prostate Hyperplasia

What is benign prostate hyperplasia or BPH?

The prostate is a small gland in the pelvis classically described as the size of a walnut or chestnut. It is about 30 g or 1 ounce large. It sits just beneath the bladder. The urethra, which is the small tube where urine exits the bladder, runs right through the center of the prostate gland, continuing out the penis. The prostate has several functions, which include the production of fluid for semen, closing the urethra up toward the bladder during ejaculation, and converting normal testosterone to a stronger version named dihydrotestosterone (DHT).

Benign means it’s noncancerous

BPH is the benign noncancerous growth of prostate cells that occurs as men age. This process is present in 50% of men over the age of 50. The percentage increases with age, reaching 90% once men reach the age of 85. The degree of enlargement is variable in men, with some men having slight enlargement and other men having their gland triple or quadruple in size. We do not fully understand why this occurs. We do know that there is a relationship between BPH and DHT. There are other risk factors that correlate with the development of BPH, such as obesity and the related insulin resistance and hypertension, age, and genetics.

Effects of the prostate growing

As the prostate grows, it can begin to cause issues to the base of the bladder and the segment of the urethra it surrounds. The portion of the prostate called the transitional zone will compress on the urethra, causing static obstruction of the urine flowing out of the bladder. This will require more contractile force by the bladder to get urine past the prostatic urethra. This may result in hesitation, weak steam, and straining to start urination. The prostate gland can also grow superiorly into the floor of the bladder, changing the normal structure of the bladder neck and causing problems initiating urination. There is also a decrease of the smooth muscle and collagen within the prostate, making the gland stiffer and causing more resistance.

Together these changes result in the retention of urine within the bladder and changes to the bladder wall, both of which further increase the frequency of urination during the day and at night. These symptoms are referred to as lower urinary tract symptoms or LUTS.

Contact a specialist about your benign prostate hyperplasia

Symptoms of an enlarged prostate gland do not have to be part of the aging process. There are conservative therapies, medications, and minimally invasive treatments. If you are experiencing any of the symptoms, you should seek evaluation by a specialist.


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