Understanding benign prostate enlargement: Symptoms, causes, and treatment

Written in association with: Mr Nikesh Thiruchelvam
Published: | Updated: 14/11/2024
Edited by: Conor Lynch

Benign Prostatic Enlargement (BPE), also known as benign prostatic hyperplasia (BPH), is a common condition in aging men. It refers to the non-cancerous enlargement of the prostate gland, a walnut-sized organ located below the bladder. As men age, the prostate tends to grow, potentially leading to uncomfortable urinary symptoms.

 

The main function of the prostate is to produce seminal fluid, but its growth can obstruct the flow of urine by pressing against the urethra, which passes through the prostate. BPH is not linked to prostate cancer, though the two conditions can coexist.

Symptoms of BPH

As the prostate enlarges, men may experience various urinary problems. The most common symptoms include difficulty starting urination, a weak or interrupted urine stream, and the frequent need to urinate, especially at night (nocturia). Some men may also feel the urge to urinate but find it difficult to fully empty their bladder. In severe cases, urinary retention—an inability to urinate—can occur, which may require urgent medical intervention.

 

Causes of BPH

The exact cause of BPH is not fully understood, but it is primarily related to hormonal changes as men age. Testosterone levels decrease, while the production of dihydrotestosterone (DHT), a hormone that stimulates prostate growth, continues. Genetic factors, obesity, and a sedentary lifestyle may also contribute to the condition. It is more common in men over 50, and the risk increases with age.

 

Treatment options

Treatment for BPH depends on the severity of the symptoms. Mild cases may only require lifestyle adjustments, such as reducing caffeine and alcohol intake or practicing bladder training techniques. Medications like alpha-blockers or 5-alpha reductase inhibitors can relax the muscles of the prostate or reduce its size.

 

 

For more severe cases, minimally invasive procedures such as transurethral resection of the prostate (TURP) or laser therapy may be recommended to remove excess prostate tissue and improve urine flow.

 

While BPH is a benign condition, it can significantly affect quality of life. If symptoms are bothersome, early consultation with a healthcare provider can lead to effective management and relief.

By Mr Nikesh Thiruchelvam
Urology

Mr Nikesh Thiruchelvam is a highly-experienced consultant urologist based in Cambridge. He has a specialist interest in all aspects of urinary dysfunction and treatment, in addition to benign prostate enlargement, vasectomy, and reverse vasectomy. Mr Thiruchelvam is celebrated for performing the first Urolift procedure in Cambridge, and runs a specialist vasectomy reversal clinic using microsurgical techniques. He enjoys excellent reviews from patients praising his clear explanations and high level of care and attention.

Originally qualifying from St Bartholomew’s Hospital Medical College in London, Mr Thiruchelvam pursued specialist training at leading centres of urological excellence including St. Bartholomew’s, the Royal London Hospital, Ipswich Hospital and Great Ormond Street Hospital. Over the course of his career Mr Thiruchelvam has secured multiple fellowships to travel to the USA and Australia, studying cutting edge techniques in treating prostate enlargement and urinary incontinence. He completed an MD in London, and was appointed Consultant Urologist at Cambridge University Hospitals in 2009.

Widely published in textbooks, patient guides, and peer-reviewed journals, Mr Thiruchelvam is highly-regarded for his extensive knowledge in the basic science of urology as well as surgical best practice. He is a significant contributor to NICE consultations, NHS Horizon Scanning documents, NICE Eyes on Evidence and NIHR Design for Dignity. Internationally, Mr Thiruchelvam is a co-author to the European Association of Urology Guidelines for Urinary Incontinence, invited faculty of European School of Urology and is regularly invited to lecture at urology conferences abroad and undertake Visiting Professorships.

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