LUTS, brought on by BPH, can present a multitude of symptoms, including pain, which can become increasingly bothersome to men as they grow older. When these symptoms begin to become problematic it’s a good idea to schedule a checkup with a healthcare professional. Benign prostatic hyperplasia is typically diagnosed by a urologist, but a primary care physician familiar with BPH symptoms and who can order the proper tests can also provide a diagnosis. Unfortunately, benign prostatic hyperplasia is common in aging men and eventually nearly every man will experience BPH if they live long enough.
BPH Symptoms that Can Cause Pain
BPH pain can occur due to certain lower urinary tract symptoms, or LUTS. However, prostate tenderness and pain can also be caused by acute prostatitis (bacterial infection of the prostate). In addition, BPH can contribute to the possibility of getting prostatitis, but the two are completely separate issues.1
The enlarged prostate can cause LUTS by putting pressure on the urethra, which is the tube that carries urine from the bladder out of the body. It can also put pressure on the bladder. This pressure can cause some symptoms that could be painful, including:
- Urinary retention
- Difficulty starting urination
- Pushing to urinate
- Urinary urgency
- Urge incontinence
- Blood in the urine
In some cases, benign prostatic hyperplasia can lead to more serious complications, such as urinary tract infections, prostatitis, kidney stones, bladder decompensation, or kidney failure. While it may be prudent to take a watchful waiting approach if BPH symptoms are mild and responsive to lifestyle changes, once BPH symptoms become more moderate or severe, it is a good idea to begin more aggressive treatment by employing BPH medication, a minimally invasive BPH procedure or surgery to address LUTS brought on by BPH.
There is no absolute cure for BPH, aside from completely removing the prostate, but there are many treatments that can shrink prostate tissue and greatly relieve symptoms both temporarily and long-term. Treatment options include:
- Lifestyle Changes: Good lifestyle modifications to head off or address benign prostatic hyperplasia include losing weight, exercising regularly, reducing stress, Kegel exercises, eating more fruits, vegetables, whole grains, nuts, seeds, fish, and vegetables, controlling the amount of dietary fat, possibly drinking alcohol in moderation and completely emptying the bladder each time.
- Medications: Several medications can help shrink the prostate gland (5-alpha-reductase inhibitors) or relax the muscles around the urethra (alpha-blockers).
- Surgery: If lifestyle changes and medications are not effective, surgery may be an option. Some good surgical procedures exist which are minimally invasive and can be utilized to treat BPH.
BPH Pain Treatment
Pain is not an overly common symptom when describing the effects of benign prostatic hyperplasia, but some men may describe pain or discomfort in the groin, lower abdomen, or pelvic area. Often, this pain is due to the enlarged prostate putting pressure on surrounding tissue or causing a urinary obstruction. If pain or discomfort is experienced with BPH, it is important to contact a doctor so the doctor can perform an examination, assess the symptoms and perform any additional tests such as a prostate-specific antigen (PSA) test, blood test, or any imaging to rule in/out possible pain causes.
Treatment options for BPH-related pain often center on managing the underlying condition. Suggestions such as lifestyle changes that allow for the avoidance of caffeine and fatty foods, limiting the intake of fluids before bedtime, logging enough sleep, getting regular exercise and maintaining a healthy weight can help with managing benign prostatic hyperplasia and any pain that may be experienced. Trying to empty the bladder as much as possible each time, without straining, is another way to minimize any fluid retention discomfort. Anyone who has experienced bladder pain when unable to find a bathroom when the urge hits, or not being able to urinate at all because of acute urinary retention, knows that the pain can be severe due to the pressure the confined urine places on the bladder. Both chronic and acute urinary retention can cause life-changing and life-threatening issues respectively, so it is a matter of importance to address.
Managing BPH Pain
If experiencing any lower urinary tract symptoms due to benign prostatic hyperplasia, or BPH, discomfort, or pain, it is important to schedule a visit with a doctor. Early diagnosis and treatment of benign prostatic hyperplasia can help prevent complications and improve the quality of life.
Here are some tips for managing BPH pain:
- Drink plenty of fluids: This will help to keep the urine flowing and reduce the risk of urinary tract infections. Moderate consumption of alcohol may help with BPH2
- Avoid caffeine: Sodas, energy drinks, and coffee can irritate the bladder and worsen symptoms.
- Empty the bladder fully: This will help prevent the bladder from becoming overfull and causing pain.
- Avoid straining when urinating: This can put pressure on prostate tissue, the urethra, and the bladder, thus worsening symptoms.
- See a doctor: If symptoms are not getting better or if they are causing significant discomfort, a diagnosis should be sought from a urologist or primary care physician.
If experiencing pain or discomfort from benign prostatic hyperplasia, it is important to speak with a doctor about the best way to manage lower urinary tract symptoms, or LUTS, associated with BPH. Lifestyle changes for addressing prostatic hyperplasia can be successful in mild cases. With moderate BPH symptoms, medications could be a solution for addressing LUTS brought on by BPH if surgery is not desired. However, some BPH medications can come with potentially unwanted side effects such as ejaculatory or erectile dysfunction. With more severe BPH cases minimally invasive procedures or surgery may be needed to get true relief.
Even though BPH is not prostate cancer, and doesn’t lead to cancer, prostate cancer can present concurrently with BPH, so a digital rectal exam (DRE) and a PSA test that includes a Free PSA component are appropriate ways to initially investigate all possibilities. Some men can be diagnosed with BPH yet show no symptoms. Other men will only have minor LUTS with BPH, while others will have moderate to severe LUTS because of BPH. Family history can determine the odds of being diagnosed with BPH, as can lifestyle choices and environmental conditions. However, if pain or discomfort is ever part of the equation, consultation with a healthcare professional should be a priority.
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