Maggie McKay (Host): Welcome to the Better Health Podcast from Tidelands Health. I'm your host, Maggie McKay. Today we'll find out about what benign prostatic hyperplasia or BPH is and how it's different from other prostate conditions with Urologist and Urologic Oncology Specialist, Dr. Lauren Cooley. Welcome Dr. Cooley. It's so good to have you here.

Lauren Cooley, MD, PhD: Thank you Maggie. Thanks for having me.

Host: So what is BPH and how does it differ from other prostate conditions?

Lauren Cooley, MD, PhD: BPH is enlargement of the prostate that occurs for non-cancerous reasons. So this is not a cancer, but the prostate itself is growing and it causes obstruction in the tube that men are trying to urinate through. So it causes difficulty with urination.

Host: And what are the common symptoms of BPH? How can they affect a person's quality of life?

Lauren Cooley, MD, PhD: Some men start with relatively minor symptoms. So it may be waking up multiple times at night to urinate. They start to essentially have their life revolve around a restroom though, they have to go frequently. Sometimes they may leak urine. Sometimes they go when they don't wish to go. They might have to go more urgently or frequently than they wish to. They also may develop things like infections and these can really impact their quality of life.

Host: Can you explain the risk factors associated with BPH? Are there certain demographics more prone to developing this condition?

Lauren Cooley, MD, PhD: So unfortunately, BPH will almost affect all men. So there really isn't many predispositions. By 50 years of age, already 50% of men will experience symptoms, and by 80 years of age, 80% of men will experience symptoms. So it's something that all men may have to deal with during their lifetime.

Not all men will require medications or surgery for this, but it's something that everybody should be on the lookout for.

Host: What if you put it off and it grows bigger? Are there more complications? Is that dangerous? Does it turn into cancer?

Lauren Cooley, MD, PhD: So while it doesn't turn into cancer, it can affect other parts of the body. So upstream of the prostate is the bladder, and the bladder is a muscle like any other muscle in your body. And if it's overworked, over time, it can start to fail. And when your bladder fails, that means all of a sudden one day you could just stop peeing at all.

And so if you are unable to urinate, that's something that can be very concerning and require you to have to go into a hospital. It can also cause upstream complications for your kidneys. So over time, if your bladder is having difficulty emptying or you're getting infections, these things can affect your kidney function over time.

So we actually see people end up on things like dialysis because of untreated BPH.

Host: Dr. Cooley, what diagnostic tests are typically used to confirm BPH and how accurate are they?

Lauren Cooley, MD, PhD: So in the office we can do something as simple as a clinical exam where we feel the prostate and can tell you essentially how large it is. We can also look at imaging studies such as an ultrasound or a CT scan to look at the prostate. Sometimes we'll use cameras to look inside through the channel that you urinate through to look at the prostate and see how large it is and what problems it may be causing for your bladder.

Host: So let's talk about treatment options. What's available for BPH? How do they vary depending on the severity of the condition?

Lauren Cooley, MD, PhD: So if you're noticing symptoms of BPH, but it doesn't really bother you too much, it's not affecting your day-to-day life, we just observe things. If it's starting to affect your quality of life, then we move on to certain medications. These medications will help to relax the muscles in the prostate and help the urine flow out easier.

However, if the medications fail, if you can't tolerate the medications or you start to have more complications from BPH, like blood in your urine or infections or difficulty with your kidneys or bladder, then we start talking to you about surgeries that can help to treat the BPH and also these surgeries can help you get off of medications and a lot of our patients are motivated to be on the least number of medications as possible, and these surgeries are often outpatient procedures that take a very short time and can really impact your quality of life.

Host: Are there any lifestyle changes or preventive measures that can help manage or even reduce the risk of developing BPH?

Lauren Cooley, MD, PhD: Certain diet changes can be helpful. So there's certain things that you eat and drink that irritate your bladder. So for instance, caffeine, coffee, certain spicy foods, things like that can irritate the bladder. So if you're already having bladder irritation from BPH and then on top of that you're drinking and eating things that irritate the bladder, people can notice worse symptoms.

So that's one of the things we talk about at your first visit are things that you could avoid in your diet to help reduce the symptoms, and that can be very effective for many patients.

Host: Is that forever?

Lauren Cooley, MD, PhD: Well one, while it could be forever, it's mostly say, you know, you know that you're having issues in the morning, instead of having five cups of coffee, decreasing that to one or two, or at least knowing that this could be contributing to your bladder symptoms. So if you wanted to go out for a nice evening and you don't want to be getting up to go to the restroom five times during that dinner, decreasing the amount of, say, caffeine or alcohol, that's consumed, may be helpful, or ordering a not spicy dish or something like that may be more helpful.

Host: Is there anything else you'd like to add in closing that men should know about?

Lauren Cooley, MD, PhD: I think just being aware that these symptoms, while they're gradual over time, and you may start to kind of make concessions for them and say, oh, well it's normal that I go to the bathroom four times at night or it's normal that I have to go to the bathroom every hour during the day. That does not have to be your normal and there are things that we can do so that your life no longer has to revolve around you going to the restroom.

Host: Well, thank you so much for sharing your expertise. This has been very educational and useful.

Lauren Cooley, MD, PhD: Well, thank you so much for having me.

Host: Again, that's Dr. Lauren Cooley. To learn more, please visit tidelandshealth.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. Thanks for listening to the Better Health Podcast from Tidelands Health.