Benign Prostatic Hypertrophy

This is a gradual enlargement of the central portion of the prostate that compresses the urethra and causes obstruction to urine flow, giving rise to various symptoms including a weak flow of urine, urgency and nocturia (getting up from sleep to urinate). BPH is not cancer, and does not turn into cancer. BPH seems to be a normal part of ageing in men, but the degree of enlargement, as well as the severity of symptoms varies greatly.

The most important aspect of BPH and the symptoms it causes is how much it bothers the man. Many men have minor symptoms which are of no concern to them and therefore treatment is not required. However, for those whose quality of life is being affected, there are several highly effective treatment options available. Medications can relax or shrink the prostate, whereas surgical treatments remove the obstructing prostate tissue. The most commonly performed operation for BPH is a TURP (trans-urethral resection of prostate), in which a telescope is passed through the urethra to the prostate, which is then shaved away from the inside

Sometimes BPH can lead to retention of urine in the bladder, causing more than just bothersome symptoms. Bladder stones, recurrent urine infections and impaired kidney function may all be due to bladder outlet obstruction caused by BPH. In these cases, surgery is required. Alternatives to TURP include laser prostatectomy (link), and open (not radical) prostatectomy, where the inner portion of a very large prostate is removed via an incision in the lower abdomen.

Importantly, BPH is the most common cause of an elevated PSA between 4 and 10. It can therefore be difficult to distinguish it from prostate cancer unless a biopsy of the prostate is performed, as cancer typically raises PSA also.