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Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia (BPH) is when the prostate becomes enlarged and leads to trouble urinating.

Roughly 90 percent of men between the ages of 45 and 80 years old suffer from symptoms of BPH. As an urologist with WakeMed Urology, I see patients who suffer from BPH, and offer the following information about this disorder.

Symptoms of Benign Prostatic Hyperplasia

LUTS – Lower Urinary Tract Symptoms

  • Daytime frequency
  • Nocturia: waking up 2 or more times at night
  • Urgency (can’t wait)
  • Weak stream
  • Straining
  • Intermittency (Stop/Start)
  • Incomplete Emptying

To determine the severity of your symptoms, your physician will give you an International Prostate Symptom questionnaire. Your answers will generate a score that can help your doctor determine the best treatment.  Usually with a mild score, you can watch and maintain, and with a more severe score, your physician will offer options to make life easier and more comfortable.


Treatment Options for Benign Prostatic Hyperplasia

Behavioral Treatments

  • Regulate fluid intake
  • Change medications
  • Diet – Avoid excess alcohol/caffeine, highly seasoned foods or irritative foods
  • Lifestyle – increase activity

Medication Options

  • Alpha Blockers – decrease smooth muscle tone in the prostate. Side effects include dizziness, decrease in blood pressure, ejaculatory disturbance
    • Flomax
    • Uroxatral
    • Hytrin
    • Cardura
  • 5-Alpha reductase inhibitors – reduces the risk of retention and need for prostrate surgery. Side effects include gynecomastia, decreased libido, ejaculatory dysfunction, ED
    • Proscar
    • Avodart
  • Anticholinergics
    • Ditropan, Detrol, Vesicare, Sanctura, Enablex, Oxytrol, etc.
  • Beta-3 agonist
    • Myrbetriq

Surgical Options

  • Options available based on the severity of symptoms. Some procedures are office-based procedures, and others require 1 night hospital stay.
  • Improves symptoms score
  • Improve flow
  • Decrease frequency and nocturia
  • Improve quality of life indices


About Brandon Rubens, MD

Dr. Brandon Rubens is a board certified urologist with WakeMed Physician Practices – Urology. His clinical expertise lies in robotic and laparoscopic surgery, urologic cancer and general urology, including prostate enlargement, urinary incontinence, erectile dysfunction, blood in the urine and kidney stones.

Request an appointment with Dr. Rubens today.