Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate, is a common condition that affects men as they grow older. It occurs when the prostate gland gradually increases in size and begins to press on the urethra, the tube that carries urine from the bladder out of the body.
BPH is not cancer and does not increase the risk of prostate cancer. However, it can significantly affect quality of life by causing urinary problems, disrupting sleep, and increasing the risk of complications such as urinary retention and recurrent urinary tract infections. In Uganda, BPH is particularly common in men over the age of 50.
If you are experiencing difficulty passing urine, waking up several times at night to urinate, or feeling that your bladder never empties completely, it is important to seek medical advice. Through Hope Plus, you can connect with a licensed healthcare provider in minutes to discuss your symptoms, understand possible causes, and receive guidance on appropriate treatment options.
Key Takeaways
- Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland.
- It is most common in men over 50 years of age.
- Symptoms include a weak urine stream, frequent urination, and difficulty emptying the bladder.
- Untreated BPH can lead to urinary retention and recurrent infections.
- Severe cases may require surgery to relieve the blockage.
What Is Benign Prostatic Hyperplasia?
The prostate is a small gland found only in men. It sits below the bladder and surrounds part of the urethra.
As men age, the prostate often grows larger. In some men, this enlargement becomes significant enough to squeeze the urethra and interfere with the normal flow of urine.
This condition is called Benign Prostatic Hyperplasia.
The word “benign” means the enlargement is not cancerous.
What Causes Benign Prostatic Hyperplasia?
Age-Related Prostate Growth
The exact cause of BPH is not fully understood, but it is strongly linked to ageing.
As men get older, hormonal changes within the body contribute to gradual enlargement of the prostate gland.
This enlargement can slowly narrow the urethra and make urination more difficult.
Who Is at Risk?
BPH becomes increasingly common with age.
The risk is higher in:
- Men over 50 years of age
- Men with a family history of prostate enlargement
- Older adults
Many men will develop some degree of prostate enlargement as they age.
Symptoms of Benign Prostatic Hyperplasia
Symptoms usually develop gradually over months or years.
They are generally divided into obstructive symptoms and irritative symptoms.
Obstructive Symptoms
These symptoms occur because the enlarged prostate partially blocks the flow of urine.
Weak Urine Stream
The urine stream may become weaker than usual.
Many men notice that it takes longer to empty the bladder.
Straining to Pass Urine
Some men have to push or strain in order to start or maintain urination.
Hesitancy
There may be a delay between trying to urinate and urine actually starting to flow.
Intermittent Urine Flow
The urine stream may stop and start several times during urination.
Feeling That the Bladder Has Not Emptied Completely
Many men feel as though urine remains in the bladder even after finishing urination.
Irritative Symptoms
These symptoms result from irritation and changes in bladder function.
Frequent Urination
Men may need to urinate more often than usual.
Waking Up at Night to Urinate
Frequent nighttime urination, known as nocturia, is one of the most common complaints.
Sleep may be interrupted several times each night.
Urgency
There may be a sudden, strong need to urinate that is difficult to postpone.
Urge Incontinence
Some men may leak urine before reaching a toilet because the urge to urinate is so strong.
Possible Complications of BPH
If BPH becomes severe, complications can develop.
Acute Urinary Retention
The prostate may completely block urine flow.
Symptoms include:
- Sudden inability to urinate
- Severe lower abdominal pain
- A swollen bladder
This is a medical emergency that requires immediate treatment.
Recurrent Urinary Tract Infections
Urine that remains in the bladder for long periods increases the risk of infection.
Kidney Problems
Long-term obstruction may eventually affect kidney function in severe cases.
How Benign Prostatic Hyperplasia Is Diagnosed
Healthcare providers diagnose BPH using symptoms, physical examination, and investigations.
Urine Tests
Urine analysis may be performed to look for:
- Blood
- White blood cells
- Signs of infection
Kidney Function Tests
Blood tests may be used to assess kidney function and determine whether urine obstruction has affected the kidneys.
Ultrasound Scan
An abdominal ultrasound can help assess:
- Prostate size
- Bladder emptying
- Kidney health
- Urinary tract complications
Treatment of Benign Prostatic Hyperplasia
Treatment depends on the severity of symptoms and whether complications are present.
Step 1: Treat Associated Infections
If a urinary tract infection is present, healthcare providers may prescribe appropriate antibiotics.
Treating infection can help reduce symptoms and prevent complications.
Step 2: Monitor Symptoms
Men with mild symptoms may only require regular follow-up and monitoring.
Healthcare providers may assess whether symptoms are stable or worsening over time.
Step 3: Surgical Treatment for Severe Symptoms
Patients with severe symptoms or complications may benefit from surgery.
Surgical treatment aims to remove or reduce the portion of the prostate causing blockage.
Surgery may be considered when:
- Symptoms significantly affect daily life
- Recurrent urinary retention occurs
- Repeated urinary tract infections develop
- Kidney function becomes affected
- Other treatments are unsuccessful
Healthcare providers will explain the most appropriate surgical option based on the patient’s condition.
Living With an Enlarged Prostate
Many men live with BPH for years.
Simple measures that may help include:
- Seeking medical review when symptoms first appear
- Drinking adequate fluids during the day
- Avoiding excessive fluids shortly before bedtime
- Attending follow-up appointments
- Reporting worsening symptoms promptly
When Should You Seek Urgent Medical Care?
Seek immediate medical attention if you develop:
- Inability to pass urine
- Severe lower abdominal pain
- Fever with urinary symptoms
- Blood in the urine
- Signs of a urinary tract infection
- Sudden worsening of urinary symptoms
These may indicate complications that require urgent treatment.
Prevention of Benign Prostatic Hyperplasia
Because BPH is mainly related to ageing, it cannot always be prevented.
However, early diagnosis and treatment can help prevent complications and improve quality of life.
Men over 50 years of age should seek medical evaluation if urinary symptoms develop.
Frequently Asked Questions (FAQs)
Is Benign Prostatic Hyperplasia cancer?
No. BPH is a non-cancerous enlargement of the prostate gland.
At what age does BPH usually occur?
BPH is most common in men over 50 years of age.
Why does an enlarged prostate affect urination?
The prostate surrounds part of the urethra. When it enlarges, it can squeeze the urethra and restrict urine flow.
Can BPH cause urinary tract infections?
Yes. Incomplete bladder emptying can increase the risk of recurrent urinary tract infections.
What is acute urinary retention?
Acute urinary retention is the sudden inability to pass urine. It is a medical emergency that requires immediate treatment.
Does everyone with BPH need surgery?
No. Many men have mild symptoms that can be monitored. Surgery is usually reserved for severe symptoms or complications.
When should I see a healthcare provider about urinary symptoms?
You should seek medical advice if you develop a weak urine stream, difficulty urinating, frequent urination, urgency, or repeated nighttime urination.
