Published by Bupa's Health Information Team, March 2011.
This factsheet is for men who have an enlarged prostate caused by benign prostatic hyperplasia (BPH), or for anyone who would like information about it.
Benign enlarged prostate is a condition that affects many men as they get older. In some men, increased growth of the tissue in the prostate gland (known as BPH) can cause the prostate gland to become enlarged, which can make it difficult to pass urine.
Benign means non-cancerous. Many things, including prostate cancer and prostatitis can cause an enlarged prostate. This factsheet is just about enlarged prostate caused by BPH.
The prostate is a gland that produces the liquid part of semen (the fluid produced when you ejaculate). It’s about the size of a walnut and lies at the base of your bladder.
The front of your prostate surrounds your urethra – the tube that carries urine from your bladder and out through your penis. Any change in the size or shape of your prostate can narrow this tube, making it difficult for you to pass urine.
If you have BPH, a rapid growth in the cells in your prostate can lead to growth of your prostate gland. Not all men with BPH will develop an enlarged prostate.
If you have an enlarged prostate you may get symptoms such as:
If you have any of these symptoms, see your GP.
In some men, enlarged prostate can lead to more serious problems, such as the following.
The exact reasons why some men develop BPH and an enlarged prostate are not fully understood at present. However, the main risk factor is age. Nearly a third of men over the age of 50 are thought to have symptoms caused by an enlarged prostate.
Your GP will ask you about your symptoms and examine you. He or she may ask you to complete a questionnaire to assess how severe your symptoms are and how much they are bothering you.
Your GP will feel your abdomen to check whether your bladder is swollen. Your GP may suggest the following tests to rule out prostate cancer as a cause of your symptoms.
Your GP may also ask you for a urine sample and blood tests to check for urinary tract infections and check how well your kidneys are working.
Your GP may refer you to a urologist (a doctor who specialises in identifying and treating conditions that affect the urinary system) if there are any doubts about your diagnosis, or if you need surgery. The urologist may advise the following tests.
There are various treatments available for enlarged prostate. Your treatment will depend on a number of factors, including your age, your general health and the type of symptoms you have.
If you have mild to moderate symptoms that aren't bothering you much, your GP may suggest you don’t have any immediate medical treatment, but just monitor your condition with routine check-ups. Your GP may give you some advice on simple lifestyle changes you can make to improve your symptoms, such as cutting down on caffeine and alcohol and reducing the amount of fluid you drink in the evening.
He or she may also suggest a programme of exercises known as bladder training. This involves increasing how much urine your bladder can hold by trying to increase the amount of time before you need to urinate. Only do this if you are advised by your GP.
If your symptoms are bothering you, your GP may suggest treatment with one or a combination of the following medicines.
These include alfuzosin, doxazosin and tamsulosin. Alpha-blockers work by relaxing the muscles at the neck of your bladder, reducing the pressure on your urethra and increasing the flow of urine. They don’t cure BPH but may help to alleviate some of your symptoms. Alpha-blockers can be associated with side-effects such as dizziness and light-headedness, as a result of low blood pressure. Your GP can prescribe alpha-blockers. You can also buy tamsulosin from a pharmacist.
5-alpha reductase inhibitors
If you have a particularly large prostate or a high PSA level (but don’t have any signs of prostate cancer), your GP may prescribe you a 5-alpha reductase inhibitor, such as finasteride or dutasteride. These medicines work by blocking the production of a hormone called dihydrotestosterone, which can reduce the size of your prostate. They can take six months or more to work.
The most common side-effects of 5-alpha reductase inhibitors are sexual problems, including a reduced sex drive, difficulty in maintaining an erection and problems with ejaculation. However, these problems seem to affect more men during the first year of treatment and become less common as treatment continues.
If medicines don’t help to improve your symptoms, or if you have complications or your symptoms are particularly severe, your GP may refer you to a urologist for further treatment. He or she may suggest one of the following types of surgery.
New treatments, such as botulinum toxin injections, laser vaporisation techniques and laparoscopic prostatectomy are under development. You may be offered a new technique as part of a clinical trial. Ask your surgeon for more details.
There have been claims that a number of plant extracts, such as saw palmetto, are effective at treating symptoms of enlarged prostate. However, there is no good quality evidence to support these claims. In addition, these therapies are not regulated, so effective dosages and risk of side-effects are uncertain.
If you do choose to try herbal medicines, talk to your GP first.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
Most of Bupa's Health Assessments include a prostate exam and PSA blood test for men over 50. Call 0845 600 3458 quoting ref. HFS100 to book an appointment today.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: March 2011