What is benign prostate enlargement (Benign Prostatic Hyperplasia or BPH)?

Unlike other organs in the body, the prostate gland continues to grow during every man’s lifespan. The prostate grows gradually after the age of about 50 and by the age of 70, approximately 8 out of 10 men have an enlarged prostate.

Symptoms of an enlarged prostate

Approximately 1 in 3 men will experience symptoms as a result of having an enlarged prostate gland. Most commonly, these symptoms will be:
• A weak flow of urine and taking longer to empty the bladder
• Hesitancy – having to wait at the toilet before the urine starts to flow
• Problems emptying – feeling your bladder is not empty after you have been to the toilet
• Frequency – having to pass urine more often than before, often needing to get up several times during the night

The prostate gland grows like a donut around the urethra, the tube or ‘water pipe’ through which urine flows. The affect of having an enlarged prostate is like a kink developing in a water pipe – it blocks the normal flow of water. Not everyone with an enlarged prostate will develop symptoms; it depends how the prostate presses upon the urethra and lower bladder. If left untreated, an enlarged prostate resulting in urinary symptoms can lead to infections and more rarely, kidney damage.

It is important to note that not all urinary symptoms in men are the result of an enlarged prostate. If you have blood in your urine or experience pain, it is important that you have a full assessment to check whether the problems may be caused by other prostate, bladder or kidney problems.

How is an enlarged prostate diagnosed?

• A doctor may examine your prostate to feel how big it is. You may need to have blood and urine tests to check the function of your kidneys and rule out other potential problems, such as infection.
• Specialists at Birmingham Prostate Clinic use a cystoscopy, a special telescope to examine the bladder.
• You may be asked to have a urine flow test to assess the blockage and a scan to look at the prostate and the bladder.

How is an enlarged prostate treated?

Active monitoring
In some cases, it is best to monitor the patient and undertake regular assessments of the symptoms and their impact on the patient’s lifestyle. Immediate treatment may not be necessary; however it is important to assess the patient on a regular basis.

Medication
Medication can be used to relax the muscle tissue around the bladder and in most cases, there is some improvement within days, with full benefits evident by six weeks. Patients may experience side-effects and different combinations of medicines are often used to ensure the greatest benefit. It is therefore critical that the medication is managed by a specialist in prostate disorders.

Surgery
The most common operation undertaken for benign prostate enlargement is called a transurethral resection of the prostate or TURP. During this procedure the surplus parts of the prostate are removed using a heated wire in order to reduce the restriction around the urethra. Patients will spend an average of 3-4 days in hospital followed by a recovery period at home. There are several complications associated with surgery. Studies estimate around 74 per cent of men will experience retrograde ejaculation, when sperm enters the bladder instead of being expelled through the penis. Sexual dysfunction and urinary incontinence are complications affecting a smaller proportion of men after surgery.

The Birmingham Prostate Clinic no longer undertakes TURP. We recommend Green Light Laser surgery as a far more effective and beneficial treatment for the enlarged prostate. Click here to read more.