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DR.K SHARES: MY PERSONAL BPH EXPXPERIENCE

Updated: Mar 23, 2021


Dear Dr. K, I’m getting up two to three times a night to pee and the loss of sleep is killing me. What can I do?


Nightly trips to the bathroom to urinate are one of the symptoms of an enlarged prostate or benign prostatic hyperplasia (BPH). Other symptoms include:



  • Frequent or urgent need to urinate

  • Needing to get up a night to urinate-nocturia

  • Urinary hesitancy-you need to stand there for a while before things start to flow

  • Weak stream

  • Dribbling after urination

  • Incomplete emptying of the bladder-feeling like you need to go again

More severe symptoms of BPH are urinary tract infections, bleeding, and urinary blockage.


WHAT IS THE PROSTATE AND WHAT DOES IT DO?

The prostate is a walnut-sized gland that sits right below the urinary bladder. The urethra (the tube that the urine and semen pass through) goes through the middle of the prostate. If the prostate enlarges it can shut down the flow of urine.

The prostate secretes fluid that mix with the sperm and other fluids to facilitate their passage through the urethra.

The prostate often continues to grow throughout a man’s lifetime. This enlargement can lead to diminished urine flow, even total blockage which requires urgent attention. The cause for this continued growth is unclear. It may be related to a hormone imbalance. One theory is that there is a reversal of the ratio of testosterone and estrogen. (Yes, believe it or not, a man does produce estrogen. I cover that in another blog.) However, its size does not necessarily indicate whether it will cause symptoms. Some men with extremely large prostates have no symptoms, while someone with minimal enlargement will have pronounced symptoms.


WHAT ARE THE RISK FACTORS FOR BPH?

Obviously, the primary risk factor is aging. Family history of BPH in close male relatives-father, brothers, uncles-increase the chance of your developing BPH. Medical conditions such as diabetes or heart disease as well as being overweight lead to an increased risk of BPH. Low testosterone levels may also be a factor. DHT (dihydrotestosterone) is also thought to be a causative factor. DHT is produced in the prostate by the conversion of testosterone by an enzyme contained in the cells of the prostate.