According to the division of the National Institutes of Health that specializes in kidney and urology disorders, more than half of men in their 60s and 90% aged 80 and older have some symptoms of benign prostatic hyperplasia (BPH). This condition is one of the most common causes of changes in male urinary health.
BPH is not prostate cancer. It's a natural enlargement of the prostate gland, causing it to squeeze the urethra, the tube running through the prostate that carries urine from the bladder out the penis.
Symptoms of Enlarged Prostate
As the prostate gland enlarges it creates pressure on the urethra. This pressure starts causing a man urinary problems. Typical enlarged prostate symptoms include:
- the need to urinate more frequently, often waking one
- increasing trips to the bathroom
- problems starting or stopping urination
- a “feeling” that the bladder isn’t being emptied
- burning urine, even urinary tract infections
A Self-Test for Prostate Problems
The American Urological Association (AUA) has developed a simple seven point scorecard to help men analyze whether they might have prostate problems. Here are the first six questions:
- Over the past month, how often have you had the sensation of not emptying your bladder completely?
- Over the past month, how often have you had to urinate again in less than 2 hours?
- Over the past month, how often have you stopped and started when urinating?
- Over the past month, how often have you found it difficult to postpone urinating?
- Over the past month, how often have you had a weak urinary stream?
- Over the past month, how often have you had to push or strain to begin urinating?
Each man should use the following rankings to rate each question:
- Not at all = 0
- Less than 1 time in 5 = 1
- Less than half the time = 2
- About half the time = 3
- More than half the time = 4
- Almost always = 5
Now here's the last question. Note is has a slightly different ranking system:
7. Over the past month, how many times did you most typically get up to urinate from the time you went to bed until the time you got up in the morning?
- None = 0
- Once =1
- Twice = 2
- 3 times = 3
- 4 times = 4
- 5 times or more = 5
Add everything up. A ranking from 1 to 7 indicates mild BPH; 8 to 19 indicates a moderate problem, and 20 to 35 shows a severe problem. However, no man should rely on this test alone. Check the next section.
Better Diagnosing Prostate Problems
The AUA's test alone is not enough to confirm BPH, because many things can affect a man’s urine flow. Among other things, doctors have to perform several tests to rule out prostate cancer, bladder problems, and infections before they can identify BPH as the problem.
Truly diagnosing BPH is best done by a urologist, taking the following steps:
- taking a careful history
- testing bladder function
- performing a digital rectal exam
- analyzing the urine for infection and blood
- taking a PSA (prostate specific antigen) blood test (which might indicate prostate cancer, though it's usefulness keeps getting debated).
Fortunately, while annoying and uncomfortable, BPH is not inherently dangerous. Initial treatment is watchful waiting, perhaps with some lifestyle changes. Example: stop drinking liquids late at night to avoid waking (move dinner earlier if need be). Also, eliminate spicy foods and caffeine which can be irritants, spurring more frequent urination.
There is also a wide variety of medical and surgical treatment options that men and their doctors can choose from. Keep an eye out for upcoming columns here for more information.
Wendy J Meyeroff - Hi! I've been a health writer since 1987 and much of my time has been writing on issues that affect older Americans/seniors/boomers. ...
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