Benign Prostatic Hyperplasia (BPH)

• Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate gland enlarges abnormally, commonly affecting older men due to age-related hormonal changes.
• Common symptoms include frequent urination, urgency, weak urine stream, incomplete emptying, and mild lower abdominal discomfort.
• Treatment options range from lifestyle modification and medication to modern non-surgical therapies. In severe cases, surgery may be required.

As men age, many begin to notice frequent urination, especially at night, difficulty starting urination, a weak stream, or a feeling of incomplete bladder emptying. Some may also experience discomfort in the lower abdomen. These symptoms should not be ignored, as untreated enlarged prostate can significantly affect quality of life.

This article explains what benign prostatic hyperplasia is, symptoms to watch for, and modern non-surgical treatment options. Early detection and timely treatment help men return to daily life with confidence and better health.

What Is an Enlarged Prostate? Is It Dangerous?

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which is located beneath the bladder. A normal prostate weighs about 20 grams, but in BPH it may enlarge to 40–100 grams or more.
This condition is common in men aged 50 and older.

Although BPH is not cancer and not life-threatening, it can severely affect quality of life. If left untreated, complications such as urinary tract infections or kidney dysfunction may occur. Men with abnormal urinary symptoms should seek medical evaluation.

What Causes an Enlarged Prostate?

BPH is associated with aging and hormonal changes, along with other contributing factors:

• Age-related changes in male hormones

• Genetic predisposition

• Estrogen–testosterone imbalance

• Metabolic syndrome (diabetes, abdominal obesity)

• Smoking and excessive alcohol consumption

• Chronic stress affecting hormonal balance

• Long-term use of certain medications (e.g., diuretics, some blood pressure drugs)

• Chronic prostate inflammation

• High-fat diet and low intake of fruits and vegetables

Symptoms of an Enlarged Prostate

Symptoms vary by age and severity and often begin mildly but worsen over time:

• Frequent urination, especially at night

• Difficulty starting urination

• Weak or interrupted urine stream

• Incomplete bladder emptying

• Dribbling at the end of urination

• Sudden urgency or urinary incontinence

• Pain or burning during urination

• Blood in the urine

• Lower abdominal or lower back pain

• Complications such as bladder infection, bladder stones, or kidney damage in severe cases

Diagnosis of Enlarged Prostate

Doctors may perform the following evaluations:

• Medical history review and physical examination, including digital rectal examination (DRE)

• Urinalysis to rule out infection or kidney disease

• PSA blood test to assess prostate-related conditions

• Post-void residual (PVR) urine measurement using ultrasound or catheter

• Uroflowmetry to measure urine flow rate and obstruction severity

• Cystoscopy for detailed evaluation before surgery or to rule out other conditions

Treatment Options for Enlarged Prostate

1. Lifestyle Modification

Recommended for mild symptoms:

• Avoid drinking excessive fluids before bedtime

• Reduce caffeine and alcohol intake

• Practice pelvic floor (Kegel) exercises

• Avoid holding urine for long periods

• Annual health check-ups

2. Medication

For symptoms affecting daily life:

• Alpha-blockers (e.g., Tamsulosin, Alfuzosin) to relax prostate muscles

• 5-Alpha Reductase Inhibitors (e.g., Finasteride, Dutasteride) to reduce prostate size

• Combination therapy may be used for better outcomes

3. Non-Surgical Treatment Options

Modern alternatives for patients who prefer to avoid surgery:

• Rezum™ Water Vapor Therapy: Uses steam to shrink excess prostate tissue

• UroLift® System: Uses small implants to open the urinary channel without tissue removal

• Prostatic Artery Embolization (PAE): Reduces blood supply to shrink the prostate

4. Surgical and Procedural Treatment

For severe cases or complications:

• TURP (Transurethral Resection of the Prostate)

• Laser prostate surgery

• Prostatic stent placement

• Open prostatectomy for very large prostates

Prevention and Self-Care

• Maintain healthy weight

• Exercise regularly (walking, swimming, cycling, yoga)

• Avoid prolonged urine retention

• Quit smoking and limit alcohol

• Reduce evening intake of diuretics (coffee, tea, soda)

• Eat a prostate-friendly diet rich in vegetables, whole grains, and omega-3 fatty acids

• Consider supplements such as lycopene, saw palmetto, and zinc (consult a doctor first)

• Manage stress and get adequate sleep

• Annual prostate screening, especially for men aged 50 and above

Enlarged Prostate vs Prostate Cancer

• BPH is non-cancerous and causes urinary obstruction due to prostate enlargement.

• Prostate cancer involves uncontrolled cell growth and can spread if untreated.
  Although symptoms may overlap, prostate cancer requires urgent diagnosis and treatment.

Enlarged Prostate Screening and Treatment at Vibhavadi Hospital

The Urology Center at Vibhavadi Hospital provides comprehensive diagnosis and treatment for BPH, including lifestyle guidance, medication, non-surgical therapies (Rezum™, UroLift®, PAE), and surgery when necessary.
Treatment plans are individualized to achieve optimal outcomes and minimize complications.