An enlarged prostate is an increase in the size of the prostate. It is not caused by cancer. The medical term for an enlarged prostate is benign prostatic enlargement (BPE). It is also commonly known as benign prostatic hyperplasia (BPH). Hyperplasia involves an increase in the number of cells that cause the prostate to grow. An enlarged prostate is common in men over 50 years old but not all men with an enlarged prostate get symptoms. About 1 in 3 men over the age of 50 will have urinary symptoms at some stage. The most common cause of these symptoms is an enlarged prostate.
- Poor stream – Urine flow is weak and it takes longer to empty your bladder
- Waiting – You may have to wait for a while before urine starts to flow
- Frequency – You may pass urine more often than normal
- Urgency – You may have to get to the toilet quickly
- Poor emptying – You may have a feeling of not quite emptying your bladder
The diagnosis of an enlarged prostate is generally made clinically based on symptoms and a physical examination. Tests such as urine cultures for detecting infection, the prostate specific antigen (PSA) blood test, ultrasound and CT scan may be used to confirm the diagnosis or exclude other causes.
Treatment depends on the severity of your symptoms. The main treatment pathways are:
- Lifestyle changes – for example, avoid drinking before going to bed, limit alcohol and caffeine and exercise frequently.
- Medication – These may be used to relax the smooth muscle in the prostate or cause the prostate to reduce in size with time. Other medications can relax the bladder to reduce the frequency of urination.
- Surgery – This is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication. Surgery improves symptoms by removing the part of the prostate that obstructs the outflow of urine from the bladder. Examples of surgical procedures include simple prostatectomy, transurethral resection of prostate (TURP), greenlight laser prostatectomy (PVP), Holmium enucleation of the prostate (HoLEP) and Urolift.