Understanding Benign Prostate Hyperplasia (BPH): Causes, Symptoms, and Treatment Options
Benign Prostate Hyperplasia (BPH), also known as prostate gland enlargement, is a common condition affecting men as they age. Unlike prostate cancer, BPH is non-cancerous but can still cause uncomfortable urinary symptoms that impact daily life.
BPH is incredibly prevalent, particularly in men over 50, with studies suggesting that more than half of men in their 60s and up to 90% in their 70s and 80s experience some degree of prostate enlargement. While it isn’t life-threatening, the symptoms can significantly affect quality of life, from disrupted sleep due to frequent nighttime urination to the frustration of a weak urine stream.
The good news? BPH is manageable. With the right diagnosis and treatment plan—whether through medication, lifestyle adjustments, or minimally invasive procedures—men can regain control of their urinary health. In this guide, we’ll explore everything you need to know about BPH, helping you make informed decisions about your wellbeing.
What is the Prostate Gland?
The prostate is a small gland the size of a walnut that is situated below the bladder, in front of the rectum. It performs an important function in the system of the male body by secreting the fluid that makes up semen, the substance that enables sperm to swim into a female’s vagina and fertilise an egg.
The urethra, the tube that empties urine from the bladder and out of the body, passes directly through the prostate. Because of this anatomical location, when the prostate is enlarged, it has the potential to place pressure on the urethra and cause problems with urination.
Normal vs Enlarged Prostate
The prostate of a young man of health weighs about 20-25 grams. But with BPH, the prostate can become significantly larger — in some cases, double or triple its normal size. This is growth due to an increased number of cells (hyperplasia), but it is not cancerous.
Once enlarged, the swollen prostate can:
- Strictures of the urethra, which cause difficulty in passing urine.
- Irritate the bladder and cause it to fill up more, leading to more frequent urination.
- Result in incomplete emptying, causing dribbling or infections.
Causes and Risk Factors of BPH
Aging and Hormonal Changes
The main cause of BPH is hormonal changes due to age. In men, when they get older, the levels of testosterone go down, but oestrogen stays the same. Moreover, dihydrotestosterone (DHT), a metabolite of testosterone, is accumulated in the prostate and promotes cell proliferation.
Other Possible Contributing Factors
The greatest associated risk is age, but other risk factors may include:
- Genetics – You are at higher risk if BPH runs in your family.
- Lifestyle – Obesity, inactivity, and poor diet may be factors.
- Physical Conditions – Both diabetes and heart disease are associated with an increased risk of BPH.
Symptoms of BPH
The BPH symptoms are predominantly related to urination, and they can vary in intensity. They are generally recognised as two classes:
Obstructive Symptoms (Due to Blockage)
- Problems beginning urine flow (hesitancy).
- The urine stream may be weak or stop and start.
- Straining to urinate.
- Post-void dribbling.
Irritative Symptoms (related to bladder irritation)
- Urinary frequency, particularly nocturia.
- Hyperactive bladder: The feeling of needing to pee more than eight times in one day and/or needing to stay up more than once at night to use the bathroom.
- Incontinence (if unable to get to the toilet on time).
Impact on Quality of Life
If symptoms are long-term, they can cause:
- Insomnia due to nocturia.
- Fear of not being able to find a toilet when out.
- Reduced job performance and decreased social role functioning.
Diagnosis of BPH
If you have symptoms, a urologist will recommend:
Initial Physical Examination
- Digital Rectal Exam (DRE): A technique where a lubricated, gloved finger is inserted into the rectum to feel the size and texture of the prostate.
Diagnostic Tests
- Urine Test: Looks for infections or blood.
- PSA Blood Test: Tests prostate-specific antigen levels in the blood (high PSA levels might indicate BPH or cancer).
- Imaging: Ultrasound, magnetic resonance imaging, or computed tomography may evaluate the size of the prostate and bladder function.
- Biopsy (if necessary): Unnecessary unless cancer is suspected.
Difference Between BPH and Prostate Cancer
It’s very important to realise that:
- BPH is not cancer – It does not spread and rarely develops into cancer.
- Prostate cancer develops differently – it grows in a benign cell fashion but is accompanied (often) by different symptoms (bone pain in its advanced phases, for example).
Diagnostic tests, including PSA levels and biopsies, help to differentiate the two.
Treatment Options for BPH
For Mild Symptoms: Monitor and Wait
- Periodic surveillance with no active intervention.
- Lifestyle modifications may be tried initially.
Medications
- Alpha-blockers (for example, Tamsulosin) – These medications work by relaxing the muscles around the prostate so you can urinate more easily.
- 5-alpha-reductase inhibitors (Finasteride): Prostate reduces over time.
Minimally Invasive Procedures
- UroLift: Small implants hold the prostate open.
- Rezūm Therapy: Shrinks excess tissue with steam.
Surgical Options
- TURP (Transurethral Resection of the Prostate): Eradicates tissue blocking the way.
- Laser Surgery is another minimally invasive option for TURP.
Lifestyle Changes to Manage BPH
- Cut back on caffeine & alcohol – These are bladder irritants.
- Bladder training – Planning when you will go to the toilet to help control it.
- When you hydrate, restrict liquids close to bedtime.
When to See a Doctor
Consult your doctor if you have:
- Urination is painful, or there is an appearance of blood in the urine.
- Unable to urinate (emergency).
- They feel that much of a burden on your life.
Conclusion
BPH is a medical problem that is common and treatable. Whether it’s incontinence, urine leakage, passing water, or a urinary tract infection that is causing you trouble, the experts at Chase Lodge Hospital are here to support you with tailored care, from diagnosis all the way through to some of the most state-of-the-art treatment choices available. Don’t let BPH interfere with your life. Schedule an appointment today and begin your journey to better prostate health.
