Common symptoms
- Needing to pass urine often, especially at night
- Weak or interrupted urine stream
- Difficulty starting to pass urine
- Feeling that the bladder has not emptied fully
- Sudden urge to pass urine
- Inability to pass urine (urinary retention), which is an emergency
What is BPH?
The prostate is a small gland below the bladder that surrounds the urethra, the tube through which urine leaves the body. As men get older, the prostate often grows larger. This non-cancerous enlargement is called benign prostatic hyperplasia (BPH). An enlarged prostate can squeeze the urethra and make it harder to pass urine.
BPH is very common after the age of 50, and its symptoms tend to increase with age.
How is BPH diagnosed?
- A discussion of your symptoms, often using a short symptom score questionnaire
- Physical examination, including a gentle examination of the prostate
- Urine test to rule out infection
- PSA blood test, when appropriate
- Ultrasound to measure prostate size and check how well the bladder empties
- Uroflowmetry, which measures the strength of your urine stream
- Urodynamic studies in selected cases
Treatment options
Lifestyle changes: reducing fluids in the evening, cutting down on tea, coffee and alcohol, and bladder training can help mild symptoms.
Medicines: alpha-blockers relax the prostate muscle to improve flow, and 5-alpha reductase inhibitors can shrink the prostate over months. They are sometimes used together.
Surgery, when medicines are not enough:
- TURP (Transurethral Resection of the Prostate): the standard endoscopic operation to remove the obstructing prostate tissue.
- Laser enucleation of the prostate: removes the obstructing tissue with a laser, suitable for prostates of all sizes.
When to see a urologist
See a urologist if urinary symptoms affect your sleep or daily life, if you see blood in your urine, or if you cannot pass urine at all, which needs urgent care.
Treatments offered
- Lifestyle advice and watchful waiting
- Medicines (alpha-blockers, 5-alpha reductase inhibitors)
- Transurethral resection of the prostate (TURP)
- Laser enucleation of the prostate
- Catheter care for urinary retention
Frequently asked questions
Is an enlarged prostate the same as prostate cancer?
No. BPH is a non-cancerous enlargement of the prostate that is very common as men age. The two can have similar urinary symptoms, which is why your urologist may check a PSA blood test and examine the prostate.
Do I need surgery for an enlarged prostate?
Most men with mild to moderate symptoms do well with lifestyle changes and medicines. Surgery is considered when symptoms are bothersome despite medicines, or when there are complications such as urinary retention, recurrent infections, bladder stones or effects on the kidneys.
What is laser enucleation of the prostate?
It is an endoscopic procedure, done through the urinary passage, in which a laser is used to remove the obstructing part of the prostate. It is suitable even for large prostates and usually involves a short hospital stay.
This page is general information and not a substitute for a consultation. Every patient is different, and the right treatment depends on an individual assessment.