If you're a man over 50 and you've noticed changes in your urination patterns, you're not alone. One of the most common culprits is benign prostatic hyperplasia, or BPH. It’s a noncancerous enlargement of the prostate gland, and it’s incredibly common.
BPH can feel like a minor issue at first. A slight hesitation when starting to urinate. Maybe a stronger urge to go, more often than you used to. But as the prostate grows, it can press against the urethra and make bladder function more complicated than it should be.
Urologist Michael Rotman, MD, with offices on the Upper East Side of Manhattan and in Hewlett, New York, provides expert guidance on treating BPH.
Let’s explore how BPH impacts urination and what you can do about it.
The prostate is a small gland, about the size of a walnut, located just below the bladder. It surrounds the urethra, the tube that carries urine from the bladder out of the body. In young men, it’s generally not a problem. But as men age, the prostate often grows.
That growth isn’t always even or predictable. Sometimes the gland expands inward, squeezing the urethra like a kink in a hose. Other times, the prostate presses up against the bladder, triggering frequent urges to urinate. Either way, the outcome can be frustrating and disruptive.
When the prostate enlarges, it interferes with the normal flow of urine. You might find yourself waking up multiple times at night to pee. Or standing at the toilet, waiting uncomfortably, before the stream finally starts.
The symptoms of BPH can include:
These symptoms interrupt sleep, affect travel plans, work meetings, and even your confidence. It’s hard to focus when you’re constantly wondering where the nearest bathroom is.
Your bladder is a resilient organ. When BPH begins to block urine flow, the bladder compensates by working harder to push urine through the narrowed urethra. When this occurs, the bladder walls thicken and become more sensitive.
At first, this adjustment works. Over time, though, the bladder tires out. It may contract at the wrong time, leading to urgency. Or it may become weaker and struggle to empty completely, raising the risk of urinary tract infections and bladder stones.
In severe cases, untreated BPH can even lead to an inability to urinate at all, which is a medical emergency.
There are many effective treatments for BPH, ranging from lifestyle changes to medication and minimally invasive procedures.
Dr. Rotman may start with alpha-blockers, which relax the muscles around the prostate and bladder neck to improve urine flow. Another option is 5-alpha-reductase inhibitors, which help shrink the prostate over time. Some men benefit from combination therapy.
If medications aren’t effective or cause side effects, procedures like UroLift or Rezūm can relieve the obstruction without major surgery. These are typically outpatient treatments with short recovery times.
In some cases, we may recommend surgical intervention like transurethral resection of the prostate (TURP).
BPH isn’t life-threatening, but it can seriously affect your quality of life. Many men delay seeking help because they’re embarrassed or think it’s just part of getting older.
If you're experiencing urinary symptoms, don’t wait. Call, or schedule an appointment online today. A simple evaluation can help determine the cause of your urination problem and guide you toward the right treatment.
