• Feinberg School
• Northwestern
• Feinberg Faculty Profiles

Benign Prostate Diseases
  

Faculty

• Christopher M. Gonzalez, MD
• Kevin T. McVary, MD
• Anthony J. Schaeffer, MD

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia is an enlargement of the prostate gland and the most common benign tumor found in man. It occurs most often in westernized countries and may occur more commonly among African-Americans. BPH causes an obstruction of the flow of urine through the urethra. Symptoms related to BPH are present in about 1 in 4 men by age 55 and 1 in 2 men by age 75. However, it is important to remember that treatment is only necessary if symptoms become bothersome. By age 80, some 40 percent of men experience BPH symptoms severe enough to require treatment. In the past, surgery was the only treatment available; today, however, drugs which relieve the symptoms or shrink the prostate are commonly used, as are methods used to heat the prostate and improve the flow of urine.

When is BPH Treatment Necessary?

The course of BPH in a particular individual is not predictable. Symptoms and objective measurements of blockage may remain stable or improve over time; thus decisions regarding treatment should be based on the severity of the current symptoms, the extent of any damage to the urinary tract, and overall health status. In general, no treatment is indicated in those who have only a few symptoms and are not bothered by them. Intervention, generally surgical, is required with the following symptoms:

• the bladder does not empty fully;

• the presence of damage to the kidneys;

• a complete inability to urinate;

• incontinence;

• bladder stones;

• infection of residual urine; or

• recurrent blood in the urine;

as well as symptoms that trouble the patient enough to diminish his quality of life. Each person must determine whether the symptoms bother him or interfere with his life enough to merit treatment. In selecting a treatment, both the patient and the doctor must balance the effectiveness of the different forms of therapy against their side effects and cost.

Treatment Options for BPH

Currently the main treatment options for BPH are watchful waiting, medication and surgery (generally a TURP, or transurethral resection of the prostate). If medications prove ineffective in a man who is unable to withstand the rigors of surgery, urethral obstruction can be managed by intermittent catheterization.