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Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH) is a medical term to describe an enlarged prostate. Note that it is not cancer and it is not usually a serious threat to health. Benign means non-cancerous, prostatic means related to the prostate gland, and hyperplasia means an increase in the number of cells.

It is not fully understood what causes benign prostatic hyperplasia but there are two major risk factors. Primarily, the risk increases with age. Many men over 50 may have an enlarged prostate but will not experience any symptoms. Secondly, the balance of hormones in your body changes as you age and this may cause your prostate gland to grow. There are some studies which suggest obesity and diabetes increase your risk of BPH, however, more research is needed in this area.

Symptoms

As the prostate enlarges with age, this can put pressure on the bladder and urethra, which can lead to a number of lower urinary tract symptoms, such as:

  • Weak urine flow
  • Difficulty starting to urinate
  • Straining when urinating
  • Taking a long time to urinate
  • Bladder feeling full after urinating
  • A frequent and/or urgent need to urinate
  • Nocturia (getting up in the night to urinate)
  • Accidentally leaking urine

Diagnosis and treatment

To diagnose BPH, your consultant will need to do a digital rectal examination (DRE), which is a physical examination of your prostate gland.

Urine and blood tests will also be required to rule out other potential problems causing your symptoms. Finally, an ultrasound scan may be required for the specialist to review the bladder and kidneys.

Depending on the results of these tests, you may need further tests, including urodynamic measurements and transrectal ultrasonography (TRUS) to diagnose BPH. There are a number of treatments for BPH depending on the severity of your symptoms.

In some cases, simple lifestyle changes may help, and if these fail to work there are medicines available. There are several surgical treatments available, including transurethral resection of the prostate (TURP), holmium laser enucleation of the prostate and many other minimally invasive options.

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