PROSTATE HEALTH

Benign Prostatic Hyperplasia (BPH)

Patient Guide
 Table of Contents Urology Care Foundation
Prostate Health Committee
Jerry’s Story . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 CHAIR

GET THE FACTS Kevin T. McVary, MD, FACS

How Does the Prostate Work?. . . . . . . . . . . . . . . . . . . 4

What is BPH?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 COMMITTEE MEMBERS

What are the Symptoms of BPH?. . . . . . . . . . . . . . . . . 4 Lori B. Lerner, MD

What are the Causes of BPH?. . . . . . . . . . . . . . . . . . . . 4 Paul Maroni, MD

Who is at Risk for BPH?. . . . . . . . . . . . . . . . . . . . . . . . 5 Daniel Parker, MD

GET DIAGNOSED Charles Welliver, MD

Symptom Score Index. . . . . . . . . . . . . . . . . . . . . . . . . . 5

Physical Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Urine Tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Scans. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Blood Tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
GET TREATED
Active Surveillance. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Prescription Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Less Invasive surgery. . . . . . . . . . . . . . . . . . . . . . . . . . . 7
More Invasive surgery. . . . . . . . . . . . . . . . . . . . . . . . . . 8
What to Expect After surgery. . . . . . . . . . . . . . . . . . . . 9
OTHER CONSDIERATIONS
Preventing BPH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Questions to Ask Your Doctor . . . . . . . . . . . . . . . . . . . 7
GLOSSARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

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 Tracy's Story

Through a BPH patient chat group, Jerry learned about a

doctor in another city and a treatment that uses steam to
shrink the prostate. The treatment sounded promising with
few downsides. His doctor had only done it twice, so Jerry
felt he should find a doctor with more experience. After
talking with a few urologists, Jerry decided to choose a
more experienced doctor.
Jerry chose to have the steam procedure. There have been
no negative side effects and now he proudly “pees like a
20 year-old!” He was told the large median lobe has all
but disappeared.
If Jerry were to meet a man recently diagnosed with BPH,
here is what he would advise:
• First, it is important to talk about the pros and cons of
each treatment option before choosing one.
• Next, be careful of what you read online. You can learn a
A few years ago, Jerry* noticed it was getting harder to pass lot about new treatments this way, but you can also find
urine. This was not a sudden thing. It came on gradually. He a lot of bad information. If you find something you are
decided to make an appointment with a urologist nearby to curious about, ask your doctor.
learn what was going on. The doctor said that his prostate • Finally, find a doctor who has had a lot of experience with
had enlarged, but felt they could “wait and see” before whatever procedure you are interested in. Different opinions
starting treatment. Jerry was told to return in one year. always help. Experience and expertise always matter.
A year later, Jerry learned his prostate had grown from 60cc Jerry feels great now and expects to continue feeling good
to 80cc with a large median lobe. His prostate was about in the years ahead.
the size of large lemon. His symptoms were getting worse.
*Name has been changed.
Jerry’s doctor gave him some pills. The drugs made him feel
loopy and he did not feel they were helping. That is when
Jerry began to research online to find other options.

Introduction

If you have been diagnosed with Benign Prostatic immediate attention is required. But, other symptoms like
Hyperplasia (BPH), which is better known as an enlarged weak urine stream or the need to push or strain can many
prostate, you are not alone. It is a common condition for times be monitored.
men as they age. In fact, about half of all men between BPH itself may not require any treatment, but if it begins to
ages 51 and 60 have BPH. Up to 90 percent of men over cause symptoms, treatment may help.
age 80 have it.
BPH is benign. This means it is not cancer, nor does it lead to
BPH is an enlarged prostate. While the prostate is usually cancer. Still, BPH and cancer can happen at the same time.
the size of a walnut or golf ball in adult men, it can If you have symptoms, it is of great value to get a complete
grow to be as large as an orange. As the gland enlarges, diagnosis and learn what you can do to get relief. In this
it can squeeze the urethra. If you are not able to pass patient guide, we tell you about the treatments available.
urine at all (called retention) or if you have renal failure,

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 GET THE FACTS

As the prostate enlarges, it presses against the urethra.

How Does the Prostate Work? The bladder wall becomes thicker. Over time the bladder
may weaken and lose the ability to empty fully. Urine
The prostate* is part of the male reproductive system. The then remains in the bladder. These problems cause many
prostate’s main job is to make fluid for semen. It is about of the lower urinary tract symptoms (LUTS) of BPH. How
the size of a walnut and weighs an ounce or so. It sits below BPH causes symptoms may help your health care team
the bladder and in front of the rectum. It goes around a determine if and what type of treatment to suggest.
tube called the urethra. The urethra carries urine from the
bladder and out through the penis. Who is at Risk for BPH?

• Men over the age of 50 as the risk for BPH rises with age
• Men whose fathers had BPH
• Men who are overweight or obese
• Men who don’t stay active
• Some men with erectile dysfunction (ED)

What are the Symptoms of BPH?

When the prostate is enlarged, it can bother or block

the bladder. Needing to pass urine often is a common
symptom of BPH. This might include the need to pass
urine as often as every one to two hours, mainly at night.
Other symptoms of BPH are listed below:
• Incomplete emptying: the feeling your bladder is full, even
What is BPH? after passing urine.
• Frequency: the need to pass urine often, about every one
Benign prostatic hyperplasia (BPH) is when the to two hours.
prostate and surrounding tissue expands. The prostate
• Intermittency: the need to stop and start several times
goes through two main growth periods as a man ages.
when passing urine.
The first is early in puberty, when the prostate doubles
• Urgency: feeling the urgent need to pass urine as if you
in size. The second begins around age 25 and continues
can’t wait.
during most of a man's life. As you age, your prostate
may get larger. BPH is when it gets large enough to cause • Weak stream: a weak urine flow.
problems. • Straining: trouble starting to pass urine or the need to
NORMAL PROSTATE ENLARGED PROSTATE push or strain to pass urine.
• Nocturia: the need to wake up at night more than two
times to pass urine.

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*All words that appear in blue italics are explained in the glossary.
 BPH may occur when these hormone changes trigger
prostate cell growth. Another theory is about the role of
What are the Causes of BPH?
dihydrotestosterone (DHT.) This male hormone supports
prostate development. Some studies show that older men
The causes of BPH are not clear. It mainly occurs in older have higher levels of DHT. Testosterone levels go down.
men. Hormone changes are thought to play a role.
Hormones from the testis may be the main factor. For
example, as men age, the amount of active testosterone
in the blood declines. Estrogen levels stay the same.

GET DIAGNOSED

There are many tests for BPH. The following tests are used American Urological Association (AUA) developed this test
to diagnose and track BPH. to assess urinary symptoms.
This is often the first step to diagnose BPH. The score can
rate BPH as being mild to severe. You and your health care
Symptom Score Index
provider may talk about your results and your medical
history. This is sometimes also called the International
If you have any urinary changes or symptoms, your doctor Prostate Symptom Score (IPSS.)
may talk to you about the BPH Symptom Score Index.The
Rate your symptoms with the BPH Symptom Score Index below!

BPH Symptom Score Index

Less than Less than About half More than
Not at all Almost always Your score
1 time in 5 half the time the time half the time

Incomplete emptying — It does not feel 0 1 2 3 4 5

like I empty my bladder all the way.

Frequency — I have to go again less than 0 1 2 3 4 5

two hours after I finish urinating.

Intermittency — I stop and start again 0 1 2 3 4 5

several times when I urinate.

Urgency — It is hard to wait when I have to 0 1 2 3 4 5

urinate.

Weak stream — I have a weak urine 0 1 2 3 4 5

stream.

Straining — I have to push or strain to 0 1 2 3 4 5

begin urination.

None 1 time 2 times 3 times 4 times 5 times or more Your score

Nocturia — I get up to urinate after I go to 0 1 2 3 4 5

bed until the time I get up in the morning.

Total AUA Symptom Score

Total score: 0–7 mildly symptomatic; 8–19 moderately symptomatic; 20-35 severely symptomatic.
Mixed:
Quality of life due to urinary about equally Mostly
Delighted Pleased Mostly satisfied satisfied Unhappy Terrible
symptoms and dissatisfied
dissatisfied
If you were to spend the rest of your life with
your urinary condition just the way it is now, 0 1 2 3 4 5 6
how would you feel about that?

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 Physical Exam Scans

A digital rectal exam (DRE) is often the next step. These tests are done to see the size and shape of the
During a DRE, you lie on your side or bend over. The prostate. Some BPH scans include:
doctor inserts a gloved, lubricated finger into your rectum • Ultrasounds look inside the body and see the size and
to feel the back wall of the prostate gland. The health shape of the prostate.
care provider is looking for enlargement, tenderness,
lumps or hard spots. This 10-15 second exam is an • Cystoscopy is an exam used to look at the urethra or
important way to find problems. bladder with a scope.
•M
 agnetic resonance imaging (MRI) and computed
tomography (CT) are more detailed scans. These are
Urine tests done if surgery is necessary to reopen the flow of urine.
These scans provide a very clear image of the prostate
These tests are done to measure how well you release and surrounding area. It shows exactly how and where
urine. This shows the doctor if the urethra is blocked or the prostate is enlarged.
obstructed. There are several types:
• Urinalysis tests your urine sample to check for important
Blood Tests
things such as blood, signs of infection, glucose (sugar),
protein and other factors that can tell your urologist the
cause of your symptoms. Urine tests are also used to If cancer is suspected, blood tests may be done.
screen for bladder cancer. If you have blood in your urine, • Prostate-specific antigen (PSA) blood tests are used
pain or burning when you pass urine, or you cannot pass to screen for prostate cancer. The PSA blood test checks
urine, it is important to see your doctor right away. the level of PSA, a protein made only by the prostate
• Post-void residual volume (PVR) measures urine left in gland. This blood test can be done in a lab, hospital or a
the bladder after passing urine. This is done to diagnose provider's office. Avoid sexual activity several days prior to
the problem. It may also be done before surgery. the test, as this may artificially increase the PSA reading.
• Uroflowmetry measures how fast urine flows. This When the prostate is healthy, very little PSA is found
is done to diagnose the problem. It may also be done in the blood. A rapid rise in PSA may be a sign that
before surgery. something is wrong. A benign (non-cancer) enlargement
• Urodynamic pressure flow study tests pressure in the of the prostate can cause a rise in PSA levels, as can
bladder during urination. inflammation of the prostate (prostatitis). The most
serious cause of a rise in PSA is cancer.

GET TREATED

There are many treatments for BPH. You and your health
care provider will decide together which option is right Active Surveillance
for you. Mild cases may need no treatment at all. In
some cases, minimally invasive procedures (surgery Often, BPH may only require active surveillance. This
without anesthesia) are good choices. And sometimes a means your BPH will be closely watched but not actively
combination of treatments works best. treated and may be monitored with regular visits to
The main treatments for BPH are: your urologist. A yearly exam is common. Your health
• Active Surveillance care provider will look for worse or new issues before
suggesting anything else. Diet and exercise are often
• Prescription Drugs
recommended as a way to prevent or manage symptoms.
• Less Invasive Surgery
Active surveillance is best for men with mild to moderate
• More Invasive Surgery
symptoms. It is also an option for men who are not
bothered by the effects of BPH.

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 Phytotherapies or herbal therapies are not recommended
by health care providers. One popular herb is saw palmetto.
Prescription Drugs
Several important studies show they do not work. Also, the
quality and purity of supplements vary.
Prescription drugs may also be an option for men with
BPH. Types of drugs include:
Less Invasive Surgery
Alpha blockers are pills used to relax the muscles of
the prostate and bladder to reduce BPH symptoms.
They do not shrink the prostate but they may improve Less invasive surgery or minimally invasive surgical treatments
urine flow if there is a blockage. One benefit of alpha (MIST) can often be done as an outpatient, without a stay
blockers is they start to work right away. Side effects in the hospital. Recovery time is usually quicker. It can offer
may include dizziness, lightheadedness, fatigue and relief from symptoms, including urine control problems. Some
difficulty ejaculating. Men with moderate to severe BPH MISTS do not reduce your risk for another surgery or needing
and men who are bothered by their symptoms are good to take medications again. Be sure to ask your urologist about
candidates. Alpha blockers are not a good choice if you re-treatment rates whenever considering a MIST or even more
plan to have cataract surgery soon. invasive surgery.

Alpha-blocking drugs include alfuzosin, doxazosin, Good candidates include men who have taken BPH medication
silodosin, tamsulosin and terazosin. that did not work or men with the following symptoms:
• Weak stream of urine
5-Alpha reductase inhibitors are pills that can increase
urine flow and shrink the prostate by blocking DHT. DHT • Straining to start to pass urine
is a male hormone that can build up in the prostate and • Urinary tract obstruction, bladder stones and/or blood in
may cause prostate growth. These drugs may lower the your urine
risk of BPH problems and the need for surgery. Side • Incomplete emptying
effects include erectile dysfunction and reduced libido
• Bleeding from the prostate
(sex drive). You must keep taking the pills to prevent
symptoms from coming back. These may be best for men There are several types of less invasive surgeries from which to
with very large prostate glands. choose. The option will depend on the size of your prostate,
your overall health and your personal choice.
These prescription drugs may take many months to become
fully effective and include dutasteride and finasteride. Prostatic urethral lift (PUL) uses a needle to place tiny
implants in the prostate. These implants lift and compress the
Combined therapy uses both an alpha blocker and a
enlarged prostate so that it no longer blocks the urethra. These
5-alpha reductase inhibitor. They may work better together
implants stay in the body forever and are not easily removed.
than either drug does alone to stop BPH from getting worse.
PUL may be done with either local or general anesthesia.
By taking two drugs, you may have more side effects than
if you were taking just one. Some side effects may include With this treatment there are no cuts in the body and tissue is
dizziness, erectile dysfunction, weakness or lack of energy not destroyed or removed. Many men with enlarged prostates
and a drop in blood pressure when moving from sitting or and urinary symptoms are good candidates. There are fewer
lying down to standing. A urologist may add antimuscarinics sexual side effects with this, compared to other types of
for patients with overactive bladder symptoms. Overactive prostate surgery. MRI can still be done if you had a PUL. Talk
bladder is when the bladder muscles squeeze uncontrollably. to your doctor about how PUL may impact the image quality
It leads to frequent and urgent need to pass urine. It can of future MRI used for prostate cancer detection and if you
lead to incontinence (leaking). Antimuscarinics relax the are allergic to nickel, titanium or stainless steel. Current studies
bladder muscles. have evaluated five years of treatment with PUL and future
studies may help to determine long term durability.
Men with larger prostates are good candidates for this
treatment.
Possible drug combinations include:
• Finasteride and doxazosin
• Dutasteride and tamsulosin, a combination of both
medications that is available in a single tablet
• Alpha blockers and antimuscarinics

PUL Procedure
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Water vapor thermal therapy (WVTT) uses water vapor problems and a blocked prostate. Still, catheters' benefits
(steam) to destroy prostate cells squeezing the urethra. are temporary. Infection is a risk. This treatment is best for
This treatment can be done in a doctor’s office with local men who are waiting for medication to work, or waiting
anesthesia or after you have taken a pill for pain. It uses for surgery. They also help when there is an infection, or
a special handheld device with a needle at the end. It for men toward the end of their lives, when surgery is not
combines radiofrequency energy and water to create steam. advised. There are two types:
The needle and steam cause rapid cell death. The body’s • Clean, where the catheter is placed and removed every six to
natural healing response then breaks down and removes the eight hours. This can be done by yourself or by a caregiver.
dead tissue, causing the prostate to shrink. For this, the catheter is removed when the urine flow stops.
Men may be good candidates if they do not want to • Indwelling, where the catheter stays in the bladder for
take medication for BPH or if they have tried prescription longer periods of time.
drugs and found they do not work. Men who prefer not
to have surgery or want to avoid sexual side effects may
also be good candidates. More Invasive Surgery
You may have blood in your urine and need to use a
catheter for a few days. Painful or frequent urination should In severe cases of BPH or when other options fail, more
go away within about two to three weeks. Sexual side invasive surgery is recommended. Surgery is best if you:
effects, such as erectile dysfunction, are unlikely. • Are unable to pass urine
Studies currently suggest that symptom improvement lasts • Have kidney damage
for at least five years.
• Have frequent urinary tract infections
Temporary Implanted Prostatic Devices (TIPD) are • Have a lot of bleeding
placed in the prostatic urethra through a cystoscope and
• Have stones in the bladder
remain there for a period of about a week after which it is
removed by the urologist. While in position, it functions to There are several types of more invasive surgery options
re-shape the urine channel. In re-shapeing the urethra, there from which to choose. The option will depend on your
is a modest lessening of the prostatic obstruction and thus a health, your doctor’s expertise and your personal choice.
modest improvement in the symptoms of BPH and improved Options below appear in order of least invasive to most
urine flow. It is a low-risk procedure that can be inserted in invasive.
the OR or in the office. It may relieve bladder obstruction. Transurethral incision of the prostate (TUIP) is used to
TIPD poses a low risk of side effects, such as urinary tract widen the urethra if the prostate gland is small but causes
infections, urinary incontinence and scarring in the urethra. a major blockage. For TUIP, the surgeon makes small cuts
Some men have symptoms that include frequent or intense in the bladder neck, where the urethra joins the bladder
urges to pass urine and a burning feeling when passing and in the prostate. This widens the urethra and reduces
urine. the pressure of the prostate on the urethra, making
Prostate Artery Embolization (PAE) is a radiologic urination easier. The hospital stay is one to three days. A
procedure done by radiologists to block blood flow to catheter is left in your bladder for one to three days after
the prostate to try to shrink the entire gland to improve surgery. Some men need follow-up treatment. Men who
symptoms. This newer procedure does not have long term do not want a complete prostatectomy (removal of the
data to understand its durability. PAE probably improves prostate) but need surgery are good candidates.
urinary symptoms, at least for short periods measured for Photoselective vaporization (PVP) is a way to vaporize
less than a year. There is a shortage of substantial evidence prostate tissue with a high-powered laser. Most men can
to recommend PAE over more widely available minimally have a PVP without problems. The procedure is done as an
invasive therapies for the routine treatment of LUTS, but outpatient procedure at the hospital or sometimes in the
there is evidence showing a short-term benefit of PAE doctor’s office. There are few side effects. After PVP, most
compared to observation in a very select patient population. men can stop medical therapy. This method is useful for most
Catheterization uses a tube called a catheter in the bladder men except those with the largest of prostates. Because this
to drain urine. Catheters can be placed through the urethra method causes very little blood loss it is particularly useful
or via a small puncture in the bladder above the pubic in men with a higher risk of bleeding, such as those taking
bone. This option is helpful for men with bladder control blood-thinning medications or those with weak hearts.

8
 Transurethral vaporization of the prostate (TUVP) is
when the surgeon inserts a resectoscope into the urethra
with a lens, a light, and a tool that sends out an electrical
current to destroy prostate tissue. Heat from the electrical
current seals small blood vessels, reducing the risk of
bleeding. There is little bleeding or fluid absorption.
You may stay one night in the hospital and you can
usually return home without a catheter. Men with larger
prostates who wish to avoid more-invasive surgery may
be good candidates for TUVP.
Transurethral water–jet ablation (TWJA) uses high-
pressure water jets to destroy excess prostate tissue.
The surgeon first uses ultrasound to precisely map the
location of the excess tissue. Then the high-pressure
TURP procedure water jets are directed to that area. Following this, the
surgeon inserts another instrument to seal small blood
Transurethral resection of the prostate (TURP) is a vessels to reduce the risk of bleeding. The patient needs
common surgery for BPH. TURP uses electric current or to stay in the hospital one night to irrigate the bladder to
laser light to cut and remove tissue. This is done with prevent blood clots. You may need to use a catheter for
anesthesia and a tool called a resectoscope inserted about 48 hours after the procedure and should be able to
through the penis. The resectoscope provides light, go home the next day.
irrigating fluid and an electrical loop. The loop cuts tissue
Simple prostatectomy removes the entire prostate
and seals blood vessels. The removed tissue is flushed into
gland with laparoscopic or robotic-assisted surgery. It is
the bladder and out of the body with a catheter. Men
important for the surgeon to be skilled at this surgery.
who require surgery because of moderate to severe BPH
This is only offered to men with the largest of prostate
symptoms may be good candidates for TURP.
glands. This is a long- term cure. You will probably stay
Holmium laser enucleation of prostate (HoLEP) is in the hospital for a few days after surgery and your
when a surgeon places a resectoscope through the penis activities will be limited for several weeks. A catheter will
into the urethra. A laser inserted into the resectoscope usually be needed for 1 to 2 weeks while you heal.
destroys excess prostate tissue. No incisions (cuts) are
needed and there is very little bleeding. You may only
need to stay one night in the hospital. A catheter is used, What to Expect After Surgery
but it is usually removed the next day. Men with larger
prostates who wish to avoid more-invasive surgery may
For most men, symptoms of BPH improve after treatment.
be good candidates for this treatment. Men with a higher
After surgery, it can take time for sexual function to return
risk of bleeding, such as those taking blood-thinning
fully. Most experts believe that if you were able to have an
medications, may also be good candidates for HoLEP.
erection shortly before surgery, you will be able to after
Thulium laser enucleation of the prostate (ThuLEP) surgery. Your orgasm is not expected to change. In some
is similar to HoLEP but uses a different type of laser. As in cases, men can experience an issue where semen enters the
HoLEP, the surgeon places a resectoscope through the penis bladder rather than out the penis (retrograde ejaculation.)
into the urethra. A laser inserted into the resectoscope
Infection, bleeding and incontinence may also occur after
destroys excess prostate tissue. Men with larger prostates
some BPH treatments. In some cases, scar tissue may form.
who wish to avoid more-invasive surgery may be good
Side effects vary with the type of treatment you choose
candidates for this treatment. No incisions (cuts) are needed
and most side effects are temporary. Some men need
and there is very little bleeding. You may only need to stay
further or new treatment for their BPH symptoms after
one night in the hospital. A catheter is used, but it is usually
initial treatment.
removed the next day. Men with a higher risk of bleeding,
such as those taking blood-thinning medications, may also It is of great value to tell your doctor about any side effect
be good candidates for ThuLEP. you may have to get help.

9
 OTHER CONSIDERATIONS

Preventing BPH Questions to Ask Your Doctor

q A
 re my symptoms caused by an enlarged prostate gland
How can you prevent BPH? or something else?
There is no sure way to prevent BPH. Still, losing weight and q Should I be screened for prostate cancer?
eating a well-balanced diet, rich in fruits and vegetables,
q Will my symptoms get worse if I decide not to have
may help. Too much body fat may increase hormone levels
treatment?
and other factors in the blood and stimulate the growth of
prostate cells. Staying active also helps control weight and q What are the risks and benefits of each treatment?
hormone levels. q Do you have a lot of experience with the surgery you
suggest? If not, can you suggest someone who does?
How can you prevent a recurrence of BPH? q What should I expect after treatment?
Once you have been treated with surgery for BPH, taking q W
 hat side effects should I expect from treatment – and
medicine may sometimes be needed to control residual or how do I manage them?
new symptoms. Sometimes men need repeated treatment
q How should I handle incontinence?
to get rid of bothersome symptoms. In older men, it may
q What should I do if I have ED?
be possible to control the symptoms of BPH until the end
of life. q With my chosen treatment option, what are the risks
of needing more medications, procedures or a repeat
surgery?
q Can you recommend a specialist for a second opinion?

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 GLOSSARY

Active Surveillance Laparoscopic Surgery

Watching with regular physical exams, blood tests and Surgery done with thin, tube-like instruments that allow
imaging tests on a set schedule. If symptoms begin or several small incisions to be made, rather than one large
problems arise, more treatment will be offered. incision.

Anesthesia Magnetic Resonance Imaging (MRI)

General anesthesia makes you unconscious to feel no pain. Radio waves and a strong magnetic field used to make
You do not remember the procedure later. Local anesthesia highly detailed pictures of organs and tissue in the body.
numbs an area so you feel no pain while you are awake.
Penis
Benign Prostatic Hyperplasia (BPH) The male organ used for sex and to pass urine.
Enlarged prostate not caused by cancer; symptoms include
problems urinating because as the prostate grows, it Prostate
squeezes the urethra. In men, a walnut-shaped gland below the bladder that
surrounds the urethra and makes fluid for semen.
Bladder
The balloon-shaped pouch of thin, flexible muscle that holds Prostatectomy
urine in the body. Removes the entire prostate gland with laparoscopic or
robotic assisted surgery.
Computed Tomography (CT) Scan
X-rays and computer calculations used to see and measure Prostatitis
internal tissue and organs. Inflammation or infection of the prostate.

Cystoscopy Rectum
Passing a narrow, tube-like device through the urethra to The lower part of the bowel ending in the anal opening.
see the inside of the bladder and urinary tract.
Semen
Digital Rectal Exam (DRE)
The fluid that protects and energizes the sperm; also known
The insertion of a gloved, lubricated finger into the rectum as seminal fluid or ejaculate fluid.
to feel the prostate and check for anything abnormal.
Urethra
Ejaculation
A narrow tube through which urine leaves the body. In
The release of semen from the penis during sexual climax males, semen travels through this tube during ejaculation. It
(ejaculate). extends from the bladder to the tip of the penis.

Erectile Dysfunction (ED) Urine

Problems getting or keeping an erection. A liquid, usually yellow in color, made by the kidneys. It
contains wastes and water.
Incontinence
Loss of bladder control. This may be about urine leakage
(urinary) or loss of control with stool (fecal).

Invasive Surgery
Surgery that involves larger cuts into the body to complete
the task. Minimally invasive or non-invasive surgery uses
tools to make tiny cuts in the skin — or no cuts at all.

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 About the Urology Care Foundation Disclaimer

The Urology Care Foundation is the world’s leading This information is not a tool for self-diagnosis or a
urologic foundation – and the official foundation of the substitute for professional medical advice. It is not to be
American Urological Association. We provide information used or relied on for that purpose. Please talk to your
for those actively managing their urologic health and urologist or healthcare provider about your health concerns.
those ready to make health changes. Our information is Always consult a health care provider before you start
based on the American Urological Association resources or stop any treatments, including medications. For more
and is reviewed by medical experts. To learn more, visit information, visit UrologyHealth.org/Download or call
the Urology Care Foundation’s website, UrologyHealth. 800-828-7866.
org/UrologicConditions or go to UrologyHealth.org/
FindAUrologist to find a doctor near you.

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