Frequently Asked Questions – Benign Prostatic Hyperplasia
What is benign prostatic hyperplasia (BPH)?
Benign prostatic hyperplasia is the gradual, noncancerous growth of your prostate that may obstruct the flow of urine and cause problems with urination as you grow older. Prostate enlargement happens in virtually all men, though not all have urinary symptoms.
How common is benign prostatic hyperplasia?
Eventually, BPH catches up with every man, though you can always hope it will be later rather than sooner. More than half of men in their 60s and up to 90 percent of men in their 80s have at least some symptoms. In 2000, there were about 4.5 million medical visits for BPH in the United States.
What is my prostate, and where is it?
Your prostate is about the size and shape of a walnut, or a chestnut. It is located just below your bladder; the urethra, a tube that allows urine to flow out of your bladder and eventually out of your body, runs right through the middle of it. Inside your body, your prostate is also located just in front of your rectum. The rectum is the medical name for the lowest part of your large intestine, the part that opens to the outside of your body through your anus.
Because the prostate is located next to the rectum, doctors can feel one surface of the prostate by inserting a gloved finger in your rectum as part of a medical examination called the digital rectal examination.
What does my prostate do?
Although not all of the functions of the prostate are known, it is thought to primarily support reproduction. The prostate contains both glandular and muscle tissue. It secretes a fluid that mixes with your semen and is important for helping sperm to survive in the female reproductive tract after intercourse. It also helps prevent the semen from moving backward toward the bladder, when it should be expelled out through the penis during intercourse.
Do I need to have a prostate?
Your prostate is not a vital organ. You can function well (including male functions) even after the removal of prostate tissue to relieve urinary symptoms, though you should discuss potential risks with your physician before undergoing treatment. If you intend to become a father, you should also bring that up with your physician because it may affect the choice or timing of treatment, or your preparations beforehand. Ask if treatment is associated with a risk of erectile dysfunction (problems with erections) or retrograde ejaculation (sperm moving backward to the bladder instead of out through the penis during intercourse).
I don’t want to become a father (again), but I’m worried that retrograde ejaculation will be bad for my internal organs.
Retrograde ejaculation interferes with conception, but does not have any other known effects on a man’s functioning. The sperm ends up in the bladder and is eliminated in urine. It can’t move any farther back and doesn’t appear to disturb the urethra or the bladder when this happens.
Is my sexual activity the reason why I have BPH? Did I have too much (or too little)?
The number of times you have sex doesn’t appear to have any affect on risk for BPH. BPH is nearly universal in men, slowly happening over time as everyone grows older.
Why should I go to the doctor for BPH? I can manage. I don’t want treatment.
It’s very important for you to see the doctor for an examination if you have urinary symptoms. You and your doctor can then agree to simply monitor these symptoms for a while. However, there is a good reason for being examined—your doctor is checking to make sure you don’t have other conditions that need treatment.
One such condition is prostate cancer. This disease can cause some of the same symptoms as BPH. It can be present at the same time as BPH. If you have cancer of the prostate, it’s very important to catch it early, when it’s much more treatable.
Maintaining contact with your doctor and being monitored periodically is also safer for you because your urinary symptoms may suddenly worsen, making it difficult for you to urinate and causing damage to your bladder and ultimately your kidneys. Your doctor will try to suggest treatment before that happens, and will advise you on how to reach out for immediate medical help in case it does happen.
If I have prostate surgery or another type of invasive treatment, will I have to say goodbye to my sex life forever?
Any effective invasive treatment for BPH carries some risk of erectile dysfunction. Modern surgery and other invasive techniques for BPH have been refined to be much more tissue-sparing than before, so that they are less likely to damage the nerves and other tissues that make it possible to have erections. As a result, erectile dysfunction is less likely to occur as a complication of invasive BPH treatment, affecting fewer men than before. Ask your doctor to gain a clear understanding of the risks associated with any particular treatment that you are considering.
Why should I see the doctor when there are so many herbal treatments and dietary supplements available for BPH?
Because there’s no real proof that they work. Almost any type of nontraditional medication will have firm believers in how well they work and very credible anecdotes supporting this. That’s because people perceive life subjectively, and it’s very hard for any individual to separate cause and effect from anything they do without evidence gathered under rigorous, objective conditions. The U.S. Food and Drug Administration (FDA) requires this evidence before they approve prescription drugs, and they require that these drugs be manufactured and marketed in the United States without impurities or toxins that could hurt the public. Because herbal treatments and dietary supplements are not regulated by the FDA, you have no protection against this when you buy and consume them.
Should I massage my prostate to prevent or cure BPH? Should I buy an information kit that I’ve seen advertised that will tell me how this “secret technique” works?
Prostatic massage doesn’t affect BPH. Doctors will sometimes briefly massage the prostate gland as part of a medical examination so that they can get a sample of prostate gland secretions. This may be useful for laboratory analysis, especially if the doctor suspects you have an infection of the prostate. It doesn’t accomplish anything otherwise.