BPH Pain

July 17, 2023
The prostate is an important component of the male reproductive system. It sits just below the bladder, lays in front of the rectum, and straddles the urethra. When a man is in his prime, the prostate gland is about the size of a walnut, but as a man ages, the prostate continues to grow. BPH, or benign prostatic hyperplasia, is a condition unique to men and becomes more prevalent as a man grows older. BPH’s cause isn’t completely known, but it is thought to stem from hormonal changes as men age. Also known as prostatic hyperplasia or an enlarged prostate, BPH is the medical term for the excessive enlargement of prostate tissue that is common in men once they reach the fourth to sixth decades of their life and beyond. BPH is not prostate cancer and doesn’t lead to it or increase the risk of developing prostate cancer, but BPH can cause a variety of lower urinary tract symptoms, or LUTS, including possible discomfort and pain. While BPH pain isn’t typically a prominent symptom, some men may experience tenderness or some pain as the enlarged prostate begins pressing up against the urethra, bladder, and surrounding tissues. Even though benign prostatic hyperplasia is the cause of many lower urinary tract symptoms, and erectile dysfunction and ejaculatory issues can be experienced by men at the same time as other BPH symptoms, BPH does not cause these two issues. However, some medications taken to help relieve BPH symptoms can cause erectile dysfunction and ejaculatory issues. 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.   References: 1) https://www.healthymale.org.au/news/prostate-enlargement-vs-prostatitis-vs-prostate-cancer-whats- difference#:~:text=Recurring%20bacterial%20prostatitis%20can%20be,type%20of%20prostatitis%20is%20unknown. 2) https://www.urologyhealth.org/healthy-living/care-blog/2017/crucial-advice-to-help-reduce-the-risk-and-growth-of-bph

All surgical treatments have inherent and associated side effects. Individual’s outcomes may depend on a number of factors, including but not limited to patient characteristics, disease characteristics and/or surgeon experience. The most common side effects are mild and transient and may include mild pain or difficulty when urinating, discomfort in the pelvis, blood in the urine, inability to empty the bladder or a frequent and/or urgent need to urinate, and bladder or urinary tract infection. Other risks include ejaculatory dysfunction and a low risk of injury to the urethra or rectum where the devices gain access to the body for treatment. Further, there may be other risks as in other urological surgery, such as anesthesia risk or the risk of infection, including the potential transmission of blood borne pathogens. For more information about potential side effects and risks associated with Aquablation therapy for Benign Prostatic Hyperplasia (BPH) treatment, speak with your urologist or surgeon. Prior to using our products, please review the Instructions for Use, Operator’s Manual or User Manual, as applicable, and any accompanying documentation for a complete listing of indications, contraindications, warnings, precautions and potential adverse events. No claim is made that the AquaBeam Robotic System will cure any medical condition, or entirely eliminate the diseased entity. Repeated treatment or alternative therapies may sometimes be required.

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