Recent Blog Articles

Men's Health

Exercise and benign prostatic hyperplasia (BPH)

April 26, 2011

Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Comments

Bob Myers
June 30, 2017

I have proven to myself that walking even at a moderate ace for 20 min. per day has made a huge difference in my urine stream for the better. It works.

I to have been the victim of an over zealous PA at a urologist’s office who was quick to pass judgement on a PSA and ordered a biopsy which resulted in 10 samples being taken via the rectum I bleed for two weeks before the bleeding entirely ceased. I will never submit to such a “rush to judgement” again.

I understand that there is a clinic in Las Vegas which performs the prostate MRI’s mentioned above.

Hope this helps.

narayanakumar
March 7, 2017

Dear sir,
i have slight bph, aged 52. My friends advice me to take regular and compulsory intercourse with my wife to control bph. In what way it will be helpful.pl advice.thank you

Ted
June 10, 2017

Good comments and reply I find good to read.

Chauncey M. DePree, Jr., DBA
April 3, 2016

If you’re male, which includes about half the population, you’ve heard or can expect to hear from your prostate. The initial disturbance might be a sudden need to urinate. Buckle up, pal, there are more surprises to come. You’re about to be the protagonist in your very own mystery: “What the hell’s going on down there?”

My mystery started quietly enough, probably a lot like yours did or will. A physician advised me that a blood test from my annual physical showed an elevated PSA (Prostate-Specific Antigen). Urges to urinate had also begun. Without providing details, he strongly recommended I see a urologist. So, what does a PSA score mean?

A quick review of reputable medical websites, like drcatalona, mayoclinic, mdanderson, and speringprostatecenter alerted to the diagnostic ambiguity of PSA for screening of prostate cancer. Cancer? No wonder my physician sounded serious.

Diagnosis gets complicated right away. A “low” PSA, often ignored by physicians, can occur when a man suffers from aggressive prostatic cancer. At the other end of the scale, studies indicate that more often than not a “high” PSA score simply means a benign enlarged prostate, which naturally occurs in older men and is accompanied by slow flow and urges to urinate. Physicians nevertheless view a “high” PSA as sufficient reason to recommend their next step in the diagnosis of cancer, namely, a biopsy, an invasive and risky procedure, which may cause incontinence, impotence, and infection.

That seemed like a quick jump: from an ambiguous PSA screening procedure to a biopsy accompanied by significant health hazards. And not just any biopsy, but a multitude of samples, up to a dozen or more! Described as a pincushion biopsy.

I’m not alone considering PSA screening for cancer as ambiguous and a health hazard in its own right. The prevalence of false positives (“high” PSA and a biopsy that shows no cancer) led the American Urological Association to recommend against annual PSA screening for men of average risk under 55. We weren’t alone, either. The U.S. Preventative Task Force went further, recommending ending PSA screening for all men without symptoms like the urge to urinate and family history.

Medical researchers were ready with a relatively new PSA measure, which identifies three markers that more accurately signal underlying cancer than the simple PSA. Even then, the widespread presence of false positives significantly haunts the new PSA screening process.

Physicians still use the new PSA to recommend biopsy. And if annual blood tests report an elevated PSA—a doubling of the PSA score, for example—physicians argue that may indicate aggressive prostate cancer. A biopsy recommendation is bolstered by the claim that it is the gold standard for diagnosing prostate cancer. Peace of mind is the selling point. (A financial motive to rush to biopsy is the subject of another report.)

I thought there must be a better way to make a decision. The proposed biopsy was a clear and convincing motivation to investigate further. (By the way, a digital rectal exam and ultrasonography are as fraught with error as the PSA score). So, the question is, is there a diagnostic procedure that bridges the knowledge gap between PSA and biopsy?

Credible medical websites led to information about advanced multi-parametric MRI. Research supported its significantly improved diagnostic reliability over other methods. And, it’s noninvasive. The specialized MRI is not widely available but was highly recommended prior to biopsy. It offers detailed three-dimensional pictures of the prostate. Given experience and expertise of the urologist and technician, cancer can be significantly more accurately identified. Unnecessary biopsies are avoided. Furtherrmore, suspicious areas are subjected to a targeted biopsy, avoiding the traditional multitude of biopsy needles excising samples over the entire prostate. Multi-parametric MRI seemed to be the best current option for diagnosis and, if necessary, treatment.

The urologist showed me a video, which was a rapid display of pictures offering the impression of moving through the prostate. He said it looked clear except for one suspicious area. The suspicious area was a close call whether to biopsy. I chose the peace of mind a targeted biopsy would give me. Good or bad, I decided to know. If it were cancer, treatment would also be targeted, preserving essential functions of the prostate.

The samples were benign. Phew! Keep in mind, though, a false negative (the test procedure missed cancer) is possible. And I could still suffer cancer in the future. Therefore, I also chose to undergo periodic noninvasive monitoring via MRI.

Cancer tends to focus attention, directing one’s radar antenna to look for medical progress. Amazing cancer treatments are available and more are coming online in the near future. For starters, look up “liquid biopsy” and the “suicide gene.”

All in all, uncertainty reigns “down there,” but I’m pleased to say I enjoy a glass of wine from time to time, and expect to continue to in the future.

Al
September 3, 2015

Am i the only one to suspect that too much SITTING may be the culprit? Sitting long hours, whether in front of TV, video games or a computer screen in the office, might have a lot to explain for developing BPH. Too much sitting goes hand in hand with all sorts of other diseases, obesity, diabetes, aso. If you don’t sit, you are naturally moving, burning energy/fat/calories. The body is made for movement, not sitting on one’s arse all day long.

MADHUSUDAN SETHI
July 31, 2015

i AM OF 61 YRS OLD. I HAVE BPH GR.II. I DO MORNING WALK FOR75 MINUTES COVERING 5 KMS DAILY I.E. 25 MINUTES BRISK WALK AT SPEED 5KMPH AND SLOW RUNNING OF 15 MINUTES AT SPEED OF 10 KMPH AND STRECHING AND FLEXIBILITY EXERCISE OF 30 MINUTES. I TAKE SILDURA- 8 AND DARILONG 7.5. SOME DOCTORS SAY I HAVE TO TAKE FOR LIFE LONG . KINDLY ADVISE.

Krishnakant Saraf
September 2, 2016

I have got the similar problem . please send your advice .

Dillanger
January 12, 2015

Plsiaeng to find someone who can think like that

Tony
July 19, 2014

..how about NX-1207 injections?

Carl Bramson, MD
May 7, 2014

My theory why BPH decreases with excercise? Increased testosterone receptors on muscle cells with excercise competively inhibits binding of DHT to prostate tissue for BPH to ensue. Would require muscle bx for titrating amount of binding sites pre and post excercise. Would be interesting to try.

Commenting has been closed for this post.

Free Healthbeat Signup

Get the latest in health news delivered to your inbox!

Harvard Health Publishing Logo

Thanks for visiting. Don't miss your FREE gift.

The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School

Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more.

Harvard Health Publishing Logo

Health Alerts from Harvard Medical School

Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss...from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts.

BONUS! Sign up now and
get a FREE copy of the
Best Diets for Cognitive Fitness

Harvard Health Publishing Logo

Stay on top of latest health news from Harvard Medical School.

Plus, get a FREE copy of the Best Diets for Cognitive Fitness.