Benign prostate enlargement

When King Charles recently announced he was having surgery to treat an enlarged prostate, the UK’s National Health Service website nearly crashed as visitors to their information page on the topic shot up by 1000%! Top marks to the King for taking the unprecedented step (in royal terms) of disclosing his diagnosis and single-handedly raising awareness on this little discussed topic; prostate cancer gets a fair bit of press, but the far more common benign prostatic hypertrophy (aka BPH), not so much.

BPH is something that almost all men and those assigned male at birth will develop, starting from around 5 in 10 men in their 50s all the way up to 8 in 10 men in their 80s. Not all will experience symptoms that require surgery – in fact some men never experience any symptoms.

There are even some lifestyle tips that may help prevent BPH. Did someone say prevention?? Yes please!

Here we take a closer look at BPH including when to see your doctor and what to expect.

What is BPH?

Benign prostatic hypertrophy, also known as prostate enlargement or hyperplasia, is a non-cancerous (aka benign) enlargement of the prostate gland.

The prostate is an apricot-sized gland that sits just under the bladder and encircles the urethra, the tube that carries urine out of the bladder. The prostate’s main function is to produce the fluid that carries sperm from the testicles. After a rapid period of growth around puberty, the prostate goes quiet and then, for reasons unknown, starts slowly growing again around the age of 30-40.

What are the symptoms of BPH?

As the prostate size increases, it can press on the urethra, narrowing it to the point where it can cause difficulty passing urine. Common symptoms include:

• Needing to get up in the night to urinate
• Poor urine flow
• Difficulty starting urination, or dribbling at the end
• Feeling like the bladder isn’t fully emptied after going
• Urgency – needing to go all of a sudden
• Needing to go more often during the day

These symptoms can range from very mild and not much of a bother through to quite distressing and interfering with daily life.

And as noted above, many men experience no symptoms.

What causes BPH and can it be prevented?

We don’t yet fully understand why the prostate enlarges with increasing age, it’s possibly something to do with hormonal changes, but there are some other known factors that increase the risk:

• Having a family history of BPH
• Obesity
• A diagnosis of metabolic syndrome, high blood pressure or diabetes
• A diet low in fruit and vegetables and high in processed foods

All of which means you may be able to lower your risk by:

• keeping your weight in the healthy range
• eating plenty of fresh fruit and veg and cutting down on the processed stuff
• getting regular health checks for diabetes, blood pressure and metabolic syndrome.

And in even better news, BPH does not increase your risk of developing prostate cancer.

What else could it be and when should you see your doctor?

You should always see your doctor if you have urinary symptoms. Early prostate cancer rarely causes symptoms, but it’s not unheard of. If you have a family history of prostate cancer you should see your doctor.

There are other conditions that can mimic BPH, such as an infection in the prostate or bladder and these need to be treated quick smart. Other red flag symptoms to get checked out straight away include:

• Fever or feeling unwell
• Blood in the urine
• Unable to pass urine
• Painful urination
• Unusual discharge from the penis
• Urinary incontinence

How is BPH diagnosed?

Your doctor will take a history of your symptoms and examine you. They may do a rectal examination to check the size and feel of the prostate and order blood tests, urine tests and an ultrasound.

What are the treatment options?

Treatment of BPH depends on the symptoms and how much they interfere with your daily life. If the symptoms are mild then your doctor may suggest:

• Cutting down on alcohol and caffeine drinks, especially at night
• Avoiding spicy or acidic foods – these can irritate the bladder
• Losing some weight if necessary
• Managing constipation
• Trying some pelvic floor exercises
• Certain medications may help

For symptoms that are more severe and impacting your life, surgery is an option. Your doctor will likely refer you to a urologist to have a chat about the different types of procedures available.

All in all, we’d like to thank King Charles (we’re sure he’s reading our newsletters ????) for turning the spotlight on this common and manageable condition. If you are experiencing any of these symptoms or would just like to have a chat about prostate health, we urge you to make an appointment with your doctor today.