When you have a healthy prostate, you may hardly notice it's there. The walnut-sized male sex organ, located just below the bladder, makes fluid that nourishes and transports sperm. But as you age, the prostate can enlarge, impacting your quality of life.

If you're experiencing a weak urine stream or trouble starting your stream, have to push or strain to urinate, or have difficulty emptying your bladder, you might have an enlarged prostate, also known as benign prostatic hyperplasia or BPH. While it has nothing to do with prostate cancer, the condition should still be taken seriously. Left untreated, an enlarged prostate can lead to a sudden inability to urinate, urinary tract infections, bladder infections or kidney damage.

Read on to learn more about the causes, symptoms and treatment options.

Benign prostatic hyperplasia causes

There are many potential causes of BPH, but most experts agree that age and gender are the primary factors. A family history of BPH also increases your risk for an enlarged prostate.

"BPH rarely causes signs and symptoms in men younger than age 40," says Andrew Christiansen, MD, Nebraska Medicine urologist. "About 50% of men between ages 51 and 60 will have some signs of BPH, and that percentage increases progressively with age."

Benign prostatic hyperplasia symptoms

Common signs and symptoms of BPH include:

• Weak urine stream or a stream that stops and starts
• Difficulty starting urination 
• Inability to completely empty your bladder
• Feeling the need to push or strain
• Accidental loss or leakage of urine, also known as urinary incontinence
• Dribbling at the end of urination 
• Frequent or urgent need to urinate, especially at night 

Benign prostatic hyperplasia treatment

If you're experiencing mild to moderate symptoms of prostate enlargement, it's a good idea to bring it up with your primary care provider. However, if you're experiencing more severe symptoms, you should see a urologist to prevent permanent damage and loss of function. 

There are several effective treatment options, including:

1. Medication – Typically the first line of defense to treat symptoms, medications often require ongoing usage because they generally do not cure the issue.
2. UroLift® or prostatic urethral lift – The FDA-cleared, minimally invasive procedure lifts and holds the enlarged prostate tissue so it no longer blocks the urethra.
3. Transurethral resection of the prostate – Also known as TURP, this surgery involves inserting a scope into the urethra and cutting out pieces of the obstructing prostate tissue bit by bit using electrocautery, or heated electrodes. 
4. Laser vaporization of the prostate – This procedure uses a laser to vaporize the obstructing tissue and open up the urinary channel. 
5. Holmium laser enucleation of the prostate – Also known as HoLEP, this procedure uses a scope and laser to completely core out the enlarged prostate tissue and maximally open up the urinary channel. This procedure is used for prostates of all sizes. 
6. Simple prostatectomy – An open or robotic surgical procedure removes the majority of the prostate gland, including all of the enlarged and blocking prostate tissue. This is generally only utilized for very large prostates. 

As a board-certified urologist, Dr. Christiansen specializes in the treatment and management of BPH. He was also the first health care provider in Nebraska to perform HoLEP, so he brings a wealth of experience to help patients navigate surgical and nonsurgical options.

Reasons to consider BPH surgery

Surgery shouldn't be seen as a last resort. It can be a great option for men who can't take medications, want to get off medications, or desire more improvement in symptoms. 

Benefits of surgical intervention for BPH:

1. Medications must be taken long term to have continued benefit. When taken long term, medications can have significant costs. 
2. Medications have risks and side effects. Some men are not able to tolerate certain side effects, such as impaired sexual function. 
3. Surgery provides better improvement of symptoms compared to medications.
4. Early surgical intervention may help better preserve bladder function in patients with significant symptoms.
5. Surgery can be a great option for patients with complications related to an enlarged prostate.

"Every patient is different, and there are a lot of treatment options, so it can be difficult to decide which intervention to pursue," says Dr. Christiansen. "It's important to consider the size and shape of your prostate, overall health, as well as your symptoms and goals in terms of urinary and sexual function, to determine what's right for you."