Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is a common, benign (not cancerous) condition as men age in which the prostate gland enlarges. The prostate is a walnut-sized gland that produces fluid that contributes to semen, the fluid that transports sperm. Located below the bladder and surrounding the urethra (the tube carrying urine out of the body), the growing prostate can squeeze the urethra and cause difficulty with urination.

BPH is a very common condition, and Dr. Fenig is an expert in the latest treatment options. 


BPH is related to the normal aging process and influenced by the male hormone testosterone. More than half of men age 50 and older and 90 percent of men age 80 and older have BPH.



An enlarged prostate can cause a variety of urinary symptoms including:

  • Weak or interrupted urine stream
  • Increasingly frequent urination, especially at night
  • Difficulty starting urination
  • Inability to completely empty the bladder
  • Urinary incontinence (leakage)

Caffeine, alcohol, spicy or acidic foods, certain cold medications, anesthesia, pain medication, and constipation can make symptoms worse. Left untreated, symptoms may worsen over time and can cause complications that may include inability to urinate (urinary retention), bladder or kidney damage, bladder stones or urinary tract infections.


Diagnosis of BPH

Dr. Fenig will take a complete medical history and perform a physical examination, including a digital rectal exam (DRE). He may also order a prostate specific antigen (PSA) test. Elevated levels of PSA can indicate BPH, prostatitis (prostate inflammation) or prostate cancer.

Additional tests may include:

  • Uroflow: This measures the flow and force of your urine stream and is often performed in patients who have an obstruction or other problems with urination. To perform the test properly, it is important that you arrive for your appointment with a normally full bladder and feel the normal urge to urinate. You will be instructed to urinate into a toilet that is specially equipped to electronically measure the volume and flow of your urine. Forcing urination with a partially full bladder or waiting until your bladder is overfull, distended, and uncomfortable can give inaccurate results on the uroflow test.
  • Bladder Ultrasound (post void residual): this test is a non-invasive ultrasound test that assesses the ability of the bladder to empty.
  • Cystoscopy: Dr. Fenig utilizes a small telescope to look inside the bladder. This is a minimally invasive outpatient procedure which lasts less than five minutes. It allows Dr. Fenig to assess your internal prostate size and your bladder for stones, tumors, and signs of obstruction or other abnormalities that may cause your symptoms.
  • Urodynamics:  a procedure which helps determine whether a blockage of the prostate is the cause of your urinary symptoms
  • Transrectal ultrasound: ultrasound to assess prostate size


Learn about the treatment options for BPH here.