My presentation at Patient Perspectives, as part of the AUA Annual Meeting in San Antonio in May 2024, is accompanied by PowerPoint slides and entitled “BPH and Me: A Livestream of Urinary Issues.” It delves into my journey of living with lower urinary tract symptoms, also known as benign prostatic hyperplasia (BPH), which serves as a primary reason for male visits to urologists.

As defined by the National Cancer Institute,¹ BPH is “a benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine” in men. Taken from an exceptionally comprehensive article by the Urology Care Foundation™, “What is Benign Prostatic Hyperplasia (BPH)?,”² I refer to several diagrams of the prostate and a table that lists every symptom I have experienced (Figures 1-5).

In my talk I will also include an attendant health condition, overactive bladder (OAB), which “…causes sudden urges to urinate that may be hard to control. There might be a need to pass urine many times during the day and night. There also might be loss of urine that isn’t intended, called urgency incontinence.”³ Both men and women may experience OAB as the symptoms originate in the bladder.

I further refer to the January 2024 issue of The Journal of Urology®, which includes an article entitled: “Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023,” discussing “effective evidence-based management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH).”⁴

My narrative begins with my initial encounters with symptomatic urinary issues—from the bladder and prostate—and a confirmation of my enlarged prostate before a diagnosis of low-risk prostate cancer, for which I am currently following the management option of active surveillance. The pivotal moment when I discovered my prostate size precipitated a quest for a deeper understanding and management of my urinary issues.

The presentation also outlines my approach to managing these issues, and I will emphasize a collaborative effort with health care professionals. I’ll highlight the importance of lifestyle interventions, the role of BPH specialists, support groups, and staying informed about the latest advancements in the field, including research from social media. I’ll detail my adoption of practices like stricter sleep regimens, dietary changes, rigorous exercise, and reduced intake of fluids, particularly those containing caffeine and alcohol, as part of a comprehensive strategy to mitigate symptoms. I’ll additionally touch upon the attendant challenges I have faced in dealing with UTIs, side effects from surgeries, general anesthesia, and catheterizations.

I’ll discuss quality of life issues, reflecting on the early years of living with these urinary symptoms, and I’ll share my experiences of depression, periods of lack of motivation, and anxiety and isolation. Travel and participation in recreational activities were notably affected, illustrating BPH and OAB’s profound impact on my daily life and well-being. As I grew more aware of lifestyle changes, my quality of life significantly improved. Despite my challenges, this transformation underscores the possibility of living a happier, more engaged life.

I want to share this journey with health care professionals as I advocate for a model of shared decision-making between medical teams and patients. My goal is to enhance the understanding and management of BPH and OAB, hopefully improving the lives of those affected by these conditions and inspiring a more empathetic and collaborative approach that can ultimately achieve a better quality of life through informed patient-centered care.