DEAR DOCTOR K: I have BPH. I have some urinary symptoms, but because I work from home they’re not difficult to manage. Is there any danger in not actively treating my condition?
DEAR READER: Benign prostatic hyperplasia, or BPH, is the most common cause of prostate enlargement. As the name suggests, BPH is harmless; it does not lead to prostate cancer.
Up to two-thirds of men with BPH never develop any symptoms. Others find that BPH can make life miserable. You seem to be somewhere in between.
The most common symptoms of BPH involve changes or problems with urination. They include:
• a hesitant, interrupted or weak urine stream;
• a strong urge to urinate repeatedly throughout the day and night, even if there’s not a lot of urine in the bladder;
• leaking or dribbling urine;
• a sense of incomplete emptying;
• more frequent urination, especially at night.
If your symptoms don’t bother you too much, you and your doctor may choose to do nothing other than watchful waiting. This involves regular monitoring but no treatment. Most physicians advise against active treatment for men with mild symptoms because the side effects of the treatment can outweigh the potential benefits.
Even if you choose to forgo treatment, your doctor should regularly monitor you for complications. BPH can increase your risk of urinary tract infections and, possibly, bladder stones. The increased risk of infection comes from difficulty in fully emptying the bladder. If all the urine is not emptied out of the body, bacteria in the urine that remains inside the bladder can multiply rapidly.
Several medications exist to treat BPH Also, surgical treatments are more effective and have fewer side effects than ever before.
Usually, though, patience and lifestyle changes can give sufficient relief, and that’s what I recommend first.