What is prostate enlargement or benign prostatic hyperplasia?

Benign prostatic hyperplasia (hy-per-play-see-ah), or BPH, is a non-cancerous enlargement or growth of the prostate gland. It’s the most common prostate disease. As the prostate surrounds the top part of the urethra (the urine passage between the bladder and the tip of the penis), when your prostate grows, it makes the urethra narrower and puts pressure on the base of the bladder. This can affect the passing of urine in a number of ways.

BPH isn’t usually life threatening, but some of its symptoms can have an impact on your life. Although it can be uncomfortable, your doctor should be able to recommend treatments that help.

Male anatomy_Diagram

What makes my prostate grow?

The male sex hormone testosterone makes the prostate grow in size. As you get older, the prostate grows larger. At puberty, your testosterone levels start to increase, and the prostate grows to about eight times its size. It continues to grow, doubling in size between the ages of 21 and 50, and almost doubles again between the ages of 50 and 80. We still don’t fully understand the reasons for this ongoing growth.

How common is BPH?

BPH is more common when you get older, usually starting after 40 years of age and affecting nearly all men at some time in their lives. Some people don’t have any symptoms, even though their prostate has grown larger. BPH usually becomes more of a problem over time, with symptoms getting worse if left untreated.

What causes BPH?

We don’t understand the causes of BPH very well. Genetics might play a part – if your father was diagnosed with BPH, you’re more likely to develop prostate disease.

Older age and testosterone are both linked with BPH, but might not be the cause.

We do know that BPH only happens when testosterone is present.

What are the symptoms of BPH?

If you have BPH, you might not have any noticeable symptoms. However, a common symptom is a change to your urination, because BPH affects the part of the prostate that surrounds the top part of the urethra.

Lower urinary tract symptoms (LUTS) is a common term used to describe a range of urination symptoms. LUTS linked to BPH can cause some discomfort, or block the urine passage, but you might have other symptoms as well. It can be hard to start urinating, or the flow slows to a dribble. Other symptoms include urgent, frequent and painful urination.

What can I do if I’m having these symptoms?

If you're experiencing any of these symptoms, the best thing to do is to visit your doctor.

How is BPH diagnosed?

Your doctor will probably ask for your personal and family medical history and a description of your symptoms. They might also give you a physical examination and take blood or urine tests. A biopsy (a small surgery that removes tissue samples to study) or ultrasound might be needed to check whether the problem is BPH, prostate cancer or prostatitis. But remember, BPH is more likely to be the cause than prostate cancer.

What treatments are there for BPH?

If you have LUTS (lower urinary tract symptoms) linked with BPH, it’s important to think about how much the symptoms are bothering you before deciding on treatment.

If your symptoms are mild, it might be best not to have any treatment, as treatment side effects can affect your quality of life more than your initial symptoms prior to treatment. There are medicines that can help if you have mild to moderate symptoms. If your symptoms are moderate to severe, there are a number of surgery options with varying risks and benefits.

Because BPH can affect your relationships, it can help to include your family or partner in the treatment process.

Can I do anything to prevent BPH?

We don’t know what causes BPH or how to prevent it. But we do know that lifestyle changes can help to stop the symptoms getting worse, and might even help to improve things. You could think about:

  • Reducing or cutting out caffeine and alcohol, which irritate the bladder

  • Avoiding things that make you constipated

  • Reducing your weight

  • Controlling diabetes and blood pressure

  • Quitting smoking

  • Increasing exercise.

Although it can be difficult to talk about your prostate, it’s important to see your doctor if you start noticing any symptoms.

Your doctor’s appointment

Questions to ask your doctor

  • What tests will I need for BPH?

  • What treatment options are available for BPH?

  • What are the risks or potential side-effects associated with treatments for BPH?

Things to think about before your appointment

  • Have you had problems or changes to urinating? How would you describe these problems? i.e. frequent, urgent, weak stream.

  • Have you ever had a urine infection?

  • How much do your symptoms bother you?

  • Do you have a family history of prostate troubles?

Email these questions to yourself to take into your doctor's appointment.


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Prostate enlargement (BPH)