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For most men, during the first forty years or so of life, the prostate is on its best behavior. But after age 40, many men—an estimated 80 percent by age 80— develop benign prostatic hyperplasia (BPH), an irritating condition that causes the prostate to swell and interfere with urine flow. BPH may trigger frequent urination (several times an hour); a sense of urgency; a long wait for urine to flow; frequent awakening in the night to urinate; interruption of the urine stream (starting and stopping); and a constant feeling of fullness in the bladder. Sometimes, BPH leads to urinary tract infections; in rare cases, it can cause damage to the bladder or kidneys.
BPH develops from the inside outward, as the prostate’s inner tissue starts to crowd the urethra, which runs through the encircling prostate like a straw held in someone’s fist. As the inner prostate cells grow, they begin squeezing the urethra; the fist tightens. For most men with BPH, this tightening causes an irritating but still tolerable change in quality of life. However, when it progresses beyond the nuisance point—when it hinders the urinary tract, for example, or causes kidney or bladder problems—it needs to be treated.
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