Benign Prostatic Hyperplasia (BPH)

About the condition

Enlarged Prostate or BPH

Many men will experience trouble urinating properly as they age. An enlarged prostate, medically known as Benign Prostatic Hyperplasia (BPH), is a common cause of this. It is important to recognise the signs of an enlarged prostate and book an appointment with your healthcare professional to explore possible treatment options.

What is it?

The prostate is a walnut sized gland found in men. It lies between the penis and bladder, and wraps around the urethra (the tube that passes urine out of the body). An enlarged prostate is a benign, non-cancerous growth of this gland. By increasing in size, it puts pressure on the bladder and makes it difficult to urinate.

Who gets it?

An enlarged prostate is associated with ageing. Around 40% of men over 60 have lower urinary tract symptoms (in the bladder and urethra) due to an enlarged prostate.

Why does it happen?

The cause of an enlarged prostate is unknown. One theory is that an increase in prostate cells is linked to changing levels of hormones in older men. Testosterone levels reduce with age and men subsequently have a higher percentage of oestrogen in their body, encouraging prostate growth.

Additional risk factors

  • Studies have shown family history of BPH is a risk factor
  • Western diet and reduced exercise levels are being identified as risk factors

4 Key Facts about Enlarged Prostate or BPH

  1. Great advances have been made in medical treatments available to those experiencing urinary problems
  2. Around 40% of men over 60 have lower urinary tract symptoms due to an enlarged prostate, and quality of life is impaired in around half of these men
  3. Other possible symptoms include the need to urinate frequently but a weaker, more hesitant flow while urinating
  4. For mild cases of BPH, simple measures such as taking regular exercise and drinking less fluid before bed have been shown to help relieve symptoms If you think you may be suffering from an enlarged prostate, speak to your healthcare professional.

Further information

For further details, see the NHS leaflet here.

Benign Prostatic Hyperplasia (BPH) symptoms

Symptoms may include:

  • Peeing more often, needing to pee urgently or leaking, waking up at night to pee.
  • Feeling like your bladder doesn’t completely empty.
  • Problems with the flow of your urine.
  • You may have problems with erections.

Benign Prostatic Hyperplasia (BPH) diagnosis

Discussing your prostate and toilet habits may be embarrassing, but urinary difficulties are very common. A visit to your GP can give peace of mind and a treatment plan. Your GP will ask you about your medical history, feel your abdomen, and may use the IPSS (International Prostate System Score) to assess the severity of your symptoms. The IPSS will ask you to count how many times over the past month you have:

  • Had to push or strain to start urination
  • Found it difficult to postpone urination
  • Had a sensation of not emptying your bladder completely after you finish urinating If the results are inconclusive, your doctor may recommend one or more of the following diagnostic procedures:
  • Blood and urine tests – to check for infection, abnormal cells and that your kidneys are functioning properly
  • PSA (Prostate-Specific Antigen) test – to measure the amount of the PSA protein produced by your prostate. A high PSA could indicate either prostate cancer or BPH
  • Digital rectal exam – to assess the size and shape of the prostate
  • Urine flow test – to measure how strongly your urine is flowing and how efficiently your bladder is emptying
  • CT or ultrasound imaging scans – to build a picture of the inside of your body, revealing any possible abnormalities
  • Flexible cystoscopy – a brief examination of the bladder and urethra using a cystoscope (a thin flexible tube with a light and camera at one end). An anaesthetic gel is used to ensure procedure is more comfortable

Benign Prostatic Hyperplasia (BPH) treatment

For mild to moderate symptoms, a policy of ‘watchful waiting’ is typically implemented. This includes annual check-ups with blood and urine tests and lifestyle changes to manage the symptoms. Suggestions might include:

  • Drinking less in the evenings
  • Cutting down on caffeine and alcohol

If your quality of life is affected greatly by BPH, recommended options include:

  • Medication that can make it easier to pee and reduce the size of the prostate
  • Surgery, typically as a final resort, to remove parts of the prostate that cause blockage.

The Urology Foundation Research Update - Prostagram

Our researchers are developing the concept of a rapid MRI scan as a potential mass screening tool for prostate cancer. Prostagram is currently being evaluated across the UK as one of the biggest ever urology trials.

Watch video here

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