Benign prostate enlargement (BPE), otherwise known as benign prostatic hyperplasia (BPH), is a condition that affects older men.
It’s particularly common in men over 50 years of age and is not usually a serious threat to health.
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The prostate is a small gland seen only in men, located in the pelvis, between the penis and bladder. It’s involved in the production of semen.
The prostate generates a thick, white fluid that’s made into a thinner liquid by a protein called prostate-specific antigen (PSA). The liquid is then mixed with sperm, produced by the testicles, to create semen.
If the prostate gets enlarged, it can place pressure on the bladder and urethra (the tube through which urine passes). This can affect how you pass urine and may cause:
- difficulty starting urination
- a frequent need to urinate
- difficulty fully emptying the bladder
In some men, the symptoms are mild and do not need treatment. In others, the symptoms can be very troublesome and have a major impact on a person’s quality of life.
Many men worry that having an enlarged prostate means they have an increased risk of having prostate cancer. This isn’t the case. The risk of prostate cancer is no greater for men with an enlarged prostate than it is for men without an enlarged prostate.
What causes benign prostate enlargement?
The cause of prostate enlargement is not known, but most experts agree that it’s linked to hormonal changes that happens as a man gets older.
How is benign prostate enlargement diagnosed?
If your caregiver suspects that you have an enlarged prostate, you’ll be asked to complete a questionnaire to assess your symptoms.
Each question has five possible answers that carry a score, and your overall score shows the severity of your symptoms.
Your caregiver will also want to rule out other conditions that cause similar symptoms to prostate enlargement.
You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.
Treating benign prostate enlargement
Treatment for an enlarged prostate is known by the severity of your symptoms.
If you develop mild to moderate symptoms, you won’t get any immediate medical treatment, but you’ll have regular check-ups to carefully monitor your prostate.
You’ll probably also be advised to make lifestyle changes, such as lowering your caffeine and alcohol intake, and exercising regularly, to see if they improve your symptoms.
As well as lifestyle changes, medication is usually recommended to treat moderate to severe symptoms of benign prostate enlargement. Finasteride and dutasteride are medications that are commonly used. They block the effects of a hormone called dihydrotestosterone (DHT) on the prostate gland, which can lower the size of the prostate and improve associated symptoms.
Alpha blockers may also be prescribed. They assist to relax your bladder muscles, making it easier to pass urine. Tamsulosin and alfuzosin are two alpha blockers commonly used to treat benign prostate enlargement.
Surgery is usually only recommended for moderate to severe signs of benign prostate enlargement that have failed to respond to medication.
What are the complications of benign prostate enlargement
Benign prostate enlargement can sometimes result to complications such as a urinary tract infection (UTI) or acute urinary retention. Serious complications are rare.
How common is benign prostate enlargement?
Benign prostate enlargement is a condition linked with ageing and is common in men over 50 years of age.
Around 4 out of 10 men (40%) over 50, and 3 out of 4 men (75%) in their 70s have urinary symptoms caused by an enlarged prostate.