American Journal

University of California, San Francisco

Benign Prostatic Hyperplasia (BPH)

The prostate gland is part of the male reproductive system and is located below the bladder, in
front of the rectum and surrounds the urethra (structure that carries urine from the bladder out
through the penis). Normal prostate glands are about the size and shape of a walnut and weigh
about an ounce. The main function of the prostate gland is to produce ejaculatory fluid. The
prostate gland often enlarges with age, referred to as benign prostatic hyperplasia or BPH. This
condition can cause symptoms such as difficulty emptying bladder, need to urinate frequently,
straining, post urination dribbling or weak stream. These symptoms are referred to as lower
urinary tract symptoms (LUTS) and occur because the gland is enlarged and blocking the flow of
urine.
BPH is a common condition, estimated to affect 50% of men in their 50s and up to 90% of men
over age 80. In addition to increasing age, other risk factors include family history of BPH. BPH
is not prostate cancer, although the conditions can exist together. Men should be evaluated by a
clinician if experiencing BPH symptoms, as this is a progressive disease and can result in bladder
damage, infection or kidney damage. BPH symptoms can be treated with oral medications used
to decrease the size of the prostate (5-alpha-reducatase inhibitors) or to relax the muscles of the
prostate and bladder neck (alpha blockers). Procedures such as transurethral resection of the
prostate (TURP), microwave ablation, needle ablation or laser surgery may need to be
performed.
Recent UCSF Urology papers on BPH:
Avins AL, Bent S, Staccone S, et al. A detailed safety assessment of a saw palmetto extract.
Complementary therapies in medicine. Jun 2008;16(3):147-154.
Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. The New
England journal of medicine. Feb 9 2006;354(6):557-566.
Shinohara K. Thermal ablation of prostate diseases: advantages and limitations. International
journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology,
North American Hyperthermia Group. Nov 2004;20(7):679-697.