UnitedHealthcare of North Carolina – UPDATE 5.24.24

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Symptoms of an Enlarged Prostate (Benign Prostatic Hyperplasia – BPH)

Benign prostatic hyperplasia (BPH), or an enlarged prostate, is a common condition whose symptoms will affect nearly all men by the time they reach 80. Not only does it affect men in their retirement years, but roughly half of all men will have an enlarged prostate by age 50 and some may start having symptoms in their 40s. Given its prevalence, it’s important to recognize the symptoms of BPH and understand treatment options to help manage them.

What Causes BPH?

The prostate is a gland that makes seminal fluid. Situated just below the bladder, the prostate gland surrounds the urethra, the tube that allows urine and semen to pass out of the penis. Early on, the prostate is about the size of a walnut and grows throughout a man’s life. If it gets too large, the prostate can press against or completely block the urethra and cause problems.

No one knows for sure what causes BPH. The leading theory is that it’s caused by natural changes in hormone levels as men age. Certain risk factors may also make men more likely to develop BPH, including:

  • A family history of enlarged prostate
  • Being overweight or having obesity
  • Having heart disease or Type 2 diabetes
  • Not getting enough exercise

No matter the cause, BPH can bring uncomfortable or unwanted urinary problems that typically worsen over time.

Should I Be Worried About BPH?

BPH is not cancerous, and it’s not life-threatening. Still, it’s not something to ignore. Untreated BPH can lead to potentially serious complications, including:

  • Bladder damage
  • Bladder stones
  • Kidney damage
  • Urinary tract infections

Fortunately, treatment options are available for BPH to help manage symptoms and prevent complications.

Diagnosing Benign Prostatic Hyperplasia

The first step in diagnosing BPH is recognizing the symptoms. Symptoms of an enlarged prostate may include:

  • Urinary incontinence
  • Pain when urinating
  • Increased urinary frequency, especially at night
  • Increased urinary urgency
  • Bleeding from the prostate
  • Straining to urinate or weak urine stream
  • Incomplete emptying of the bladder
  • Intermittency

Other conditions, including prostate cancer, may cause similar symptoms. Making an appointment with your healthcare provider to talk about your symptoms early on can help you get the answers you want and the treatment you need. During your appointment, your provider will ask about your medical history and symptoms. Patients may undergo additional testing such as urine flow/dynamics test and a digital rectal exam. In some cases, a prostate-specific antigen (PSA) test is also obtained to evaluate for prostate cancer.

Imaging or image-guided tests may also be used to confirm a diagnosis, including:

  • Biopsy
  • Computed tomography (CT) scan
  • Cystoscopy
  • Magnetic resonance imaging (MRI)
  • Transrectal ultrasound

Treatments for BPH

BPH treatment will depend on your symptoms and their severity. Your provider may recommend lifestyle changes, medications, minimally invasive procedures, surgery or a combination of treatments.

Prostatic artery embolization, or PAE, is the leading non-surgical treatment for BPH. Performed by an interventional radiologist, PAE is a minimally invasive outpatient procedure that uses image guidance to thread a catheter through a tiny puncture in the groin or the wrist to access blood vessels on each side of the enlarged prostate gland. The radiologist uses small beads to block the blood flow to the prostate, which causes it to shrink. Most men notice improved symptoms within a few weeks.

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If you think your symptoms may be due to BPH, discuss it with your physician to reach a proper diagnosis and treatment plan. You can also request an appointment to consult with Charlotte Radiology Vascular & Interventional Specialists to learn more about PAE as a potential treatment option.