Conditions we treat
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, is a common non-cancerous condition affecting men as they get older. Enlargement of the prostate can compress the urethra and cause lower urinary tract symptoms such as a weak urinary stream, difficulty starting urination, urinary frequency, urgency and needing to urinate during the night.
What causes BPH?
The exact cause of benign prostatic hyperplasia (BPH) is not fully understood. Prostate enlargement becomes more common with increasing age and is thought to be influenced by changes in male hormones, including dihydrotestosterone (DHT).
BPH is very common in older men, although the degree of prostate enlargement does not always correspond with the severity of urinary symptoms. Some men with a significantly enlarged prostate have few symptoms, while others with a smaller prostate may experience troublesome urinary symptoms.
What are the symptoms of an enlarged prostate?
Benign prostatic hyperplasia can narrow the urethra and affect the way urine flows from the bladder. This can cause lower urinary tract symptoms (LUTS), which are commonly grouped into voiding (obstructive) symptoms and storage symptoms.
Voiding (Obstructive) Symptoms:
- Weak or reduced urinary stream
- Difficulty starting urination (hesitancy)
- Feeling that the bladder has not completely emptied
- Dribbling after urination
- Straining to urinate
Storage Symptoms:
- Increased urinary frequency
- Urgency to urinate
- Nocturia — needing to urinate repeatedly during the night
What are the treatment options?
Treatment for benign prostatic hyperplasia (BPH) depends on the severity of urinary symptoms, prostate size, individual anatomy and patient preferences. Not all men with an enlarged prostate require a procedure.
- Medication: Medications are commonly used to manage mild to moderate urinary symptoms. Different medications work by relaxing the prostate and bladder outlet or reducing prostate size.
- Surgery: Several surgical treatments are available for BPH, including transurethral procedures that remove or reduce obstructing prostate tissue. The most appropriate procedure depends on factors including prostate size, anatomy and individual circumstances.
- Prostate artery embolisation (PAE): PAE is a minimally invasive treatment performed by an interventional radiologist. It reduces the blood supply to the prostate, causing it to gradually shrink and potentially improve urinary symptoms. PAE may be an alternative to surgery for appropriately selected patients.