BPH (Benign Prostatic Hyperplasia)

BPH (Benign Prostatic Hyperplasia)

Benign prostatic hyperplasia ( BPH ) is a condition when the prostate gland is enlarged. As a result, the flow of urine becomes not smooth and urination feels incomplete.

The prostate gland is only owned by men. Therefore, this disease is only experienced by men. Almost all men experience an enlarged prostate, especially at the age of 60 years and over. However, the severity of symptoms can vary from patient to patient and not all prostate enlargement causes problems.

Men aged 60 years and over should have regular check-ups with the doctor, especially if they have urinary problems. If left untreated, obstructed urine flow due to BPH can interfere with kidney and bladder function. However, please note, benign prostate enlargement is not associated with prostate cancer.

Causes of Benign Prostatic Hyperplasia (BPH)

It is not known what causes benign prostate enlargement. However, this condition is thought to be related to changes in the balance of sex hormone levels as men age.

In most men, the prostate will continue to grow throughout life. When it is large enough, the prostate squeezes the urethra, the tube that carries urine from the bladder to the urethra. This condition causes the above symptoms to appear.

There are several factors that can increase a person's risk of developing a benign prostate enlargement, namely:

  • Over 60 years old
  • Lack of exercise
  • Have excess weight
  • Suffering from heart disease or diabetes
  • Regularly taking beta-blocking hypertension drugs
  • Have a family with prostate problems

Symptoms of Benign Prostatic Hyperplasia (BPH)

The severity of the symptoms of benign prostate enlargement can be different for each patient, but generally gets worse over time. The main symptom of benign prostatic hyperplasia is interference with urination, which can be:

  • Urine is difficult to pass at the beginning of urination
  • Needing to strain when urinating
  • Weak or halting urine stream
  • Urine dripping at the end of urination
  • Urination feels incomplete
  • Urinating at night becomes more frequent
  • Beser or urinary incontinence

In certain cases, BPH can even cause urinary retention or the inability to excrete urine at all. However, keep in mind, not all prostate gland enlargement causes complaints of urination, either urinating continuously or not being able to urinate at all.

When to see a doctor

Immediately consult a doctor if you experience problems when urinating, especially if accompanied by:

  • Pain when urinating
  • There is blood in the urine ( hematuria )
  • Urine does not come out at all

In addition to BPH, these symptoms can also occur due to urinary tract infections, bladder stones, kidney stones, even prostate cancer or bladder cancer. Therefore, a thorough examination by a doctor is required.

Diagnosis of benign prostatic hyperplasia (BPH)

To determine whether a patient has benign prostate enlargement, the doctor will ask about the patient's symptoms, then perform a digital rectal examination to determine the size of the prostate.

The next checks that can be carried out are:

  • Prostate ultrasound , to see the size of the patient's prostate
  • Urine test , to rule out infection or other conditions that have symptoms similar to benign prostate enlargement
  • Blood tests, to check for possible kidney disorders
  • A test for measuring antigen levels ( PSA ) in the blood. PSA is produced by the prostate and its levels in the blood will increase if the prostate gland is enlarged or impaired

In order to make sure the patient has benign prostate enlargement and rule out the possibility of other conditions, the doctor will carry out the following examinations:

  • Measure the strength of the urine stream and the amount of urine that comes out
  • Check the patient's ability to empty the bladder. Checking for the possibility of prostate cancer, through a biopsy or taking a sample of prostate tissue for examination in the laboratory
  • Seeing the condition of the urethra and bladder, by inserting a flexible tube with a camera ( cystoscope ) through the urethra

Treatment of Benign Prostatic Hyperplasia (BPH)

Treatment for benign prostate enlargement depends on the patient's age and condition, the size of the prostate, and the severity of symptoms. Treatment methods that can be done include:

Self care

If the symptoms are considered mild, the patient can perform treatment independently to relieve symptoms, namely by:

  • Avoid drinking anything 1-2 hours before bed
  • Limiting the intake of drinks containing caffeine and alcohol
  • Limit consumption of cold medicines that contain decongestants and antihistamines
  • Not holding back or delaying urination
  • Make a schedule to urinate, for example every 4 or 6 hours
  • Maintain ideal body weight, by following a healthy diet
  • Exercise regularly and regularly do Kegel exercises
  • Manage stress well


If self-medication cannot relieve symptoms, the doctor can prescribe the following medicines:

  • Alpha blockers , such as tamsulosin , to make urination easier
  • 5-al ph a reductase inhibitors , such as finasteride or dutasteride , to reduce prostate size

Research shows that drugs to treat erectile dysfunction, such as tadalafil , can also be used to treat benign prostate enlargement.


There are a number of prostate surgery methods that urologists can perform to treat benign prostate enlargement, including:

1. Transurethral resection of the prostate (TURP)

TURP is the most common surgical method for removing excess prostate tissue. In this procedure, the blocked prostate tissue is removed little by little, using a special instrument that is inserted through the urinary opening.

2. Transurethral incision of the prostate (TUIP)

TUIP does not remove prostate tissue, but makes a small incision in the prostate so that urine flows smoothly. This procedure is performed on an enlarged prostate that is small to moderate in size.

Other treatment methods

In addition to the two procedures above, blocked prostate tissue can be burned with a laser beam or removed through open surgery.

Removal of the prostate through open surgery ( prostatectomy ) is done if the size of the prostate tissue is very large or there is damage to the bladder. In this procedure, the prostate is removed through an incision made in the abdomen.

Complications of Benign Prostatic Hyperplasia (BPH)

Untreated benign prostate enlargement can lead to a number of serious complications, including:

  • Can't pee
  • Urinary tract infection
  • Bladder and kidney damage
  • Bladder stone disease

Prevention of Benign Prostatic Hyperplasia (BPH)

Benign prostate enlargement cannot be prevented. Efforts you can do is to prevent the symptoms from getting worse, namely with self-care as described above.

You can also prevent BPH from getting worse by immediately seeing a doctor as soon as you experience symptoms of a benign prostate enlargement. That way, your condition can be treated immediately before complications arise.

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