Benign Prostatic Hyperplasia (BPH) is a non‑cancerous enlargement of the prostate gland that commonly affects men over 50. As the prostate grows, it squeezes the urethra, causing urinary difficulties such as weak stream, frequent urination and nighttime waking. Left untreated, BPH can lead to urinary retention, bladder stones or kidney problems.
Causes / risk factors
- Age and hormonal changes (elevated dihydrotestosterone levels)
- Family history of BPH or prostate disease
- Obesity, sedentary lifestyle and poor diet
- Diabetes, heart disease and erectile dysfunction
- Long‑term use of certain medications (e.g., decongestants) and smoking
Symptoms
- Difficulty starting urination and weak or interrupted stream
- Urgent or frequent need to urinate, especially at night (nocturia)
- Dribbling at the end of urination and feeling that the bladder isn’t empty
- Straining or taking longer than usual to urinate
- Occasional blood in the urine and recurrent urinary tract infections
When to seek help / emergency signs
- Acute urinary retention (sudden inability to urinate)
- Blood in urine or passing clots
- Recurrent UTIs, bladder stones or kidney problems
- Persistent severe symptoms affecting sleep and daily activities
- Pain in the lower abdomen, back or perineum
Diagnosis
We evaluate medical history and perform a digital rectal exam to assess prostate size and texture. Urine and blood tests check for infection and kidney function. Prostate‑specific antigen (PSA) testing helps distinguish BPH from other conditions. Ultrasound and post‑void residual measurements assess bladder emptying, while urodynamic studies or flexible cystoscopy may be ordered for complex cases. MRI or CT scans are reserved for unusual presentations or when planning robotic surgery.
Treatment options
Treatment is customised based on prostate size, symptom severity and patient preference.
- Medications – Alpha blockers relax smooth muscle in the prostate and bladder neck; 5‑alpha reductase inhibitors shrink the gland; combination therapy may be used. Tadalafil, commonly prescribed for erectile dysfunction, can also relieve BPH symptoms.
- Minimally invasive procedures – Transurethral resection of the prostate (TURP), transurethral incision (TUIP), photoselective vaporisation (PVP) and holmium laser enucleation of the prostate (HoLEP) remove excess tissue with minimal bleeding and quick recovery.
- Water‑jet ablation and prostate artery embolisation – Emerging techniques that reduce prostate volume without cutting or burning.
- Robotic or open surgery – Recommended for very large prostates or when other treatments fail; robotic prostatectomy offers precise removal with reduced blood loss and faster recovery.
Prevention / aftercare
Maintain a healthy weight, exercise regularly and eat a diet rich in fruits and vegetables. Limit caffeine and alcohol, practise good hydration habits and avoid bladder irritants. After treatment, we provide follow‑up care to monitor symptom improvement and manage any medication side effects.