Benign Prostatic Hyperplasia
Also known as BPH, Enlarged prostate
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is benign prostatic hyperplasia?
Benign prostatic hyperplasia is age related, non cancerous growth of the prostate that can obstruct urine flow. It is very common in older men and is not prostate cancer, although the two can coexist and cause similar symptoms. Treatment is guided by how much the symptoms affect quality of life.
Causes
- Age related hormonal changes affecting prostate growth
- Dihydrotestosterone driven cell proliferation
- Increase in prostate smooth muscle tone
Symptoms
- Weak or interrupted urinary stream
- Difficulty starting urination
- Urinary frequency and urgency
- Waking at night to pass urine
- Sensation of incomplete bladder emptying
- Dribbling at the end of urination
Risk factors
- Age over 50
- Family history of prostate enlargement
- Obesity and metabolic syndrome
- Diabetes
- Physical inactivity
Diagnosis
- Symptom scoring, commonly the International Prostate Symptom Score
- Digital rectal examination
- Urinalysis to exclude infection
- PSA blood test with counselling about its implications
- Bladder scan for post void residual volume
- Urinary flow rate measurement
Treatment
- Watchful waiting for mild symptoms
- Alpha blockers to relax prostate smooth muscle
- 5 alpha reductase inhibitors to shrink the prostate over months
- Combination drug therapy
- Minimally invasive procedures such as prostatic urethral lift
- Transurethral resection of the prostate for significant obstruction
Self care
- Reduce fluids in the two hours before bed
- Cut back caffeine and alcohol, which irritate the bladder
- Take your time and try double voiding to empty fully
- Do not delay going when you feel the urge
- Review decongestants and antihistamines, which worsen symptoms
- Stay physically active and keep to a healthy weight
When to see a doctor
Book an appointment if:
- Symptoms interfering with sleep or daily life
- Weak stream that is getting worse
- Feeling the bladder never empties
- Recurrent urinary infections
- Blood in the urine
- To discuss PSA testing and what the result would mean
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Keep to a healthy weight and stay active
- Manage diabetes and blood pressure
- Limit alcohol and caffeine
- Avoid unnecessary decongestants
- Seek review early rather than adapting around worsening symptoms
Outlook
Benign prostatic hyperplasia usually progresses slowly. Many men manage well for years with lifestyle measures alone, and medication controls symptoms effectively for most of the rest. Surgery is highly effective when needed. It does not turn into prostate cancer, though the two can coexist, so new symptoms still warrant assessment.
Common questions
Does an enlarged prostate lead to prostate cancer?
No. Benign prostatic hyperplasia is not a precursor to cancer. The two conditions are separate, though both become more common with age and can occur together, so new symptoms still warrant assessment.
When does this become an emergency?
Complete inability to pass urine with a painful full bladder is acute urinary retention and needs urgent medical attention. Blood in the urine or signs of kidney impairment also require prompt review.
Do lifestyle changes help?
Yes. Limiting fluids in the evening, reducing caffeine and alcohol, allowing time to empty the bladder fully, and reviewing medicines such as decongestants can meaningfully reduce symptoms.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.