Benign prostate enlargement diagnosis: What it means, and what next?

Benign prostate enlargement, or BPE, is a very common occurrence, but what are the steps to take if you think you have it? Here to address this issue, alongside other frequently-asked questions about BPE, is leading urologist Mr Sudhanshu Chitale.

How can patients learn to live with a prostate enlargement diagnosis?

Men need to understand, and if not, should be educated, that BPE with advancing age is a norm and is as inevitable as greying hair and as such, is to be accepted as a way of life.

Men should also be aware that size of the prostate does not always equate with symptoms and that small prostates can cause as many symptoms as a large prostate; on the other hand, large prostates may not cause any symptoms at all.

Hence, men getting their prostate scanned off their own back should not get carried away by the sheer size of their prostate noted on the scan; but ought to put it in the context of their symptoms and seek appropriate advice before getting concerned or embarking on any treatment.

Men ought to be aware that we as urologists treat their prostate related symptoms and not just the size of the prostate; but prostate size matters when it comes to choosing an appropriate treatment plan for an individual case. Hence a diagnosis of BPE would be made if and when men experiencing urinary +/- sexual symptoms would seek advice from a urologist, sooner rather than later.

The take home message here for men experiencing symptoms related to their waterworks (usually related to or secondary to BPE) is not to ignore or brush aside these symptoms accepting them as a part of ageing but to get them addressed in good time, particularly if symptoms are adversely affecting their overall quality of life as well as quality of their sex life.

How will prostate enlargement affect quality of life?

BPE would tend to affect quality of life in those men experiencing symptoms related to BPE, namely:

• getting up to pass urine too often at night (or during sleeping hours);
• frequent visits to the loo during daytime upsetting day to day working life;
• urgency (sudden desire to pass urine) at times fearing, or experiencing leakage (incontinence);
• difficulty in emptying bladder;
• urinary infection with burning / stinging in passing urine;
• blood in urine or semen;
• pain in perineum (behind testes);
• threatening inability to pass urine (threatened retention), and;
• erectile dysfunction.

These BPE related symptoms as one can appreciate, affect two individuals: patient and his partner and as such, it’s advisable that men seek urgent advice re their worsening urinary and or sexual symptoms. not only to put themselves out of misery but also their partner.

How often should men go for check-ups?

Men should get themselves checked out re possible BPE as soon as they notice any of the relevant symptoms from those listed above and that they believe is adversely affecting their quality of life.

This is where an element of subjectivity or individual variation creeps in but we presently do not have a good screener or screening test for men to help diagnose BPE in the absence of symptoms.

Contrary to BPE, men with prostate cancer do not have any early symptoms indicative of cancer and as such, most men confuse BPE related symptoms for prostate cancer and urgently seek advice only to be reassured that all their symptoms are in keeping with BPE and may warrant a type of treatment based on their severity.  

Does prostate enlargement always need to be treated?

The answer is NO. As stated earlier, urologists are meant to treat or address symptoms related to BPE and not just the BPE, if it has no relevant symptoms attached to it. Moreover, there are no predictors or screeners for BPE and related symptoms, hence it is for men to volunteer and to proactively seek advice from urologists at their earliest convenience when they experience any BPE related urinary +/- sexual symptoms. Once initially and fully assessed, men can then remain under surveillance re further development of BPE and related symptoms or indeed embark on a focused treatment plan most suited for one on an individual basis.

What support is available to men with prostate enlargement?

Men with BPE related symptoms will naturally be inclined to look up for more information on Google and will only to end up feeling alarmed about the possibility of harboring prostate cancer which is not very helpful, given that prostate cancer does not cause any of their presenting symptoms. Instead, seeking advice from their GP in the first instance and/or eventually urologist would be of immense help; not only in reaching a definitive diagnosis of BPE but also allaying their anxieties re possible prostate cancer.

Looking for diagnostic expertise, or treatment, regarding BPE? Arrange a consultation with Mr Chitale via his Top Doctors profile.