What is Benign Prostatic Hyperplasia?
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. It is a very common condition that occurs as men get older.
The prostate sits just below the bladder and surrounds the urethra (the tube that carries urine from the bladder out of the body). When the prostate enlarges, it can compress the urethra and affect urine flow.
BPH is not prostate cancer and does not increase the risk of prostate cancer, although the two conditions can occur at the same time.
Benign Prostatic Hyperplasia (BPH)
How Common is BPH
BPH becomes more common with age.
Approximate prevalence:
About 50% of men over age 50
Up to 80–90% of men over age 80
Not all men with prostate enlargement develop symptoms.
Possible Complications
If BPH becomes severe or untreated, it may lead to:
Urinary retention (inability to pass urine)
Recurrent urinary tract infections
Bladder stones
Blood in the urine
Kidney problems (rare)
Symptoms of BPH
Symptoms are often referred to as Lower Urinary Tract Symptoms (LUTS) and may include:
Urinary Storage Symptoms
Frequent urination
Urgent need to urinate
Waking at night to urinate (nocturia)
Voiding Symptoms
Weak urine stream
Difficulty starting urination
Intermittent urine flow
Straining to pass urine
Post-void Symptoms
Feeling the bladder has not emptied completely
Dribbling after urination
Symptoms can vary from mild to severe.
How is BPH Diagnosed?
Your doctor may perform several tests to evaluate prostate enlargement and urinary symptoms.
Medical History and Symptom Assessment
You may be asked to complete a symptom questionnaire such as the International Prostate Symptom Score (IPSS).
Physical Examination
A digital rectal examination (DRE) allows the doctor to assess the size and texture of the prostate.
Urine Tests
Urine tests check for:
Infection
Blood in the urine
Other abnormalities
Blood Test (PSA)
A PSA (Prostate Specific Antigen) test may be performed to assess prostate health and help rule out prostate cancer.
Imaging or Other Tests
In some cases, further tests may include:
Ultrasound of the bladder or prostate
Measurement of urine flow (uroflowmetry)
Measurement of post-void residual urine
Cystoscopy
Treatment Options
Treatment depends on the severity of symptoms and how much they affect quality of life.
1. Lifestyle Measures (Watchful Waiting)
For mild symptoms, treatment may not be necessary.
Lifestyle changes may include:
Reducing evening fluid intake
Limiting caffeine and alcohol
Avoiding medications that worsen symptoms
Timed voiding
Regular follow-up may be recommended.
2. Medications
Several medications can improve symptoms.
Alpha Blockers
These medications relax the muscles of the prostate and bladder neck to improve urine flow.
Examples include:
Tamsulosin
Doxazosin
They usually work within days to weeks.
5-Alpha Reductase Inhibitors
These medications shrink the prostate by blocking hormone effects.
Examples include:
Finasteride
They may take several months to work.
Sometimes both types of medication are used together.
3. Surgical Treatment
Surgery may be recommended if symptoms are severe or complications occur.
Common procedures include:
TURP (Transurethral Resection of the Prostate)
A surgical instrument is passed through the urethra to remove part of the prostate blocking urine flow.
Laser Prostate Surgery
Laser techniques can remove or vaporise prostate tissue.
Examples include:
HoLEP (Holmium Laser Enucleation of the Prostate)
GreenLight laser therapy.
Prognosis
BPH is a chronic condition, but many men experience good symptom control with treatment.
Early assessment and appropriate management can greatly improve quality of life and urinary function.
