Benign Prostatic Enlargement

  • Benign Prostatic Enlargement is also known as benign prostatic hyperplasia (BPH). It is a benign (non-cancerous) enlargement of the prostate gland. The prostate gland usually enlarges with age. It is a common condition and about 50% of men over 50 years old have this.
  • The prostate is made up of anatomical zones. BPH typically occurs in the central and transitional zones of the prostate, and prostate cancer typically occurs in the peripheral zones of the prostate.

What are the symptoms of benign prostatic hyperplasia (BPH)? 

  • Over 50% of all men in their fifties and about 80% of men in their eighties show some symptoms of BPH. 
  • The prostate gland encircles the urethra, so when the gland enlarges, it constricts the calibre of the urethra, restricting urine flow through the wee pipe and causing a slow urinary stream. 
  • Over time, if the obstruction is not treated, it will result in bladder wall thickening and a reduction in the functional capacity of the bladder, causing urinary frequency and urge. 
  • Eventually the bladder may become weak and lose the ability to empty, thereby retaining urine.

Some of the symptoms include:

  • Urinating frequently during the day 
  • Frequent urge to urinate
  • Urinary urgency, which means the urge to urinate is so strong and sudden you may not make it to the toilet in time 
  • Waking up during the night to urinate more than once
  • The urine stream is slow or slow to start
  • Needing to strain and push to start urination
  • Dribbling at the end of urination 
  • Bladder isn’t fully emptied after urination 
  • The sensation of wanting to go again soon after urinating

How is benign prostatic hyperplasia diagnosed?

  • You may first notice symptoms of BPH yourself, or your doctor may find that your prostate is enlarged during a routine check-up. 

What are the tests require to assess BPH?

  • Urine sample: A urine sample is collected to look for signs of blood and infection. 
  • Digital rectal examination (DRE): Your doctor inserts a gloved finger into the rectum to assess the size and condition of the prostate. If your doctor feels something suspicious, such as a lump or bump, further tests will be carried out.
  • Prostate specific antigen (PSA) test: A blood sample is taken by your doctor to check for prostate specific antigen (PSA), which is an enzyme produced by the prostate. 
  • Urine flow test and bladder scan: Your doctor may ask you to urinate into a device that measures how fast the urine flows. A decrease in the flow can suggest BPH. A bladder scan is then performed to assess how much urine is left in the bladder after urination.
  • Ultrasound: Ultrasound imaging is used to estimate the size of the prostate gland and also look for growth of the prostate gland into the bladder. This can be done over the abdomen or through the rectum.

How is benign prostatic hyperplasia treated?

  • If you do not experience any symptoms of BPH, in the first instance some lifestyle modification may improve your symptoms. Your doctor may decide to wait-and-watch for the progression of the condition with regular monitoring usually once a year.
  • If your symptoms are getting worse or bothersome, your doctor may advise drug therapy, which aims at relaxing and/ or shrinking the enlarged prostate. 
  • Surgery is another option for the treatment of BPH. There are now many options for treatment of BPH including:
    • UROLIFT 
    • Transurethral resection of prostate gland (TURP, or reboring of prostate) 
    • Greenlight laser vaporisation of the prostate gland 

Disclaimer: The information on this website is provided for your general information and is not a substitute for the specific advice of your treating doctor.