Understanding benign prostatic hyperplasia (BPH)

Written by: Mr Edward Calleja
Published:
Edited by: Kate Forristal

An enlarged prostate, medically known as Benign Prostatic Hyperplasia (BPH), is a condition that affects a significant number of men, especially as they age. In his latest online article, Mr Edward Calleja gives us his insights into enlarged prostate. He talks about the common symptoms, diagnosis and tests, treatment options, risk factors and lifestyle changes or natural remedies that can relieve symptoms.

What are the common symptoms of an enlarged prostate (BPH)?

Frequent urination, particularly at night, is one of the most common symptoms of BPH, with nearly 65% of men with BPH reporting this issue. Around 40-45% of men find it hard to start urination, while about 50% experience a weakened urine stream, which may also be intermittent. In severe cases, about 20% of men report that they cannot empty their bladder.

 

 

How is an enlarged prostate diagnosed, and what are the available tests?

The first line of diagnosis is usually a digital rectal examination (DRE), effectively identifying BPH in about 75% of cases. Blood tests such as prostate-specific antigen (PSA) can help diagnose BPH. However, elevated PSA levels can also indicate other conditions like prostate cancer. Ultrasound and MRI scans are used for a more detailed assessment in about 20% of cases.

 

 

What are the treatment options for managing an enlarged prostate?

Alpha-blockers and 5-alpha reductase inhibitors are the most commonly prescribed medications, effective in 60-70% of cases.

 

Surgery Options following failed medical treatment

When medication is ineffective in alleviating symptoms, surgical options can provide relief. These include:

 

TURP (Transurethral Resection of the Prostate):

This is the most traditional surgical option and has been widely used for decades.

 

HoLEP (Holmium Laser Enucleation of the Prostate):

A minimally invasive procedure that employs laser technology to remove prostate tissue.

 

BNI (Bladder Neck Incision):

This is often used for smaller prostates and involves making small incisions in the bladder neck to improve urine flow.

 

Aquablation:

A newer, robotically guided method that uses water to remove excess prostate tissue.

 

The success rate for these surgical procedures is generally high, with around 90% of patients experiencing relief post-surgery.

 

Minimally invasive procedures

Procedures like UroLift and Rezūm are increasingly popular, with success rates of around 80%. These options are generally less invasive and have quicker recovery times than surgical methods.

 

 

What are the risk factors for developing an enlarged prostate, and can it be prevented?

Men above 50 are at a higher risk; nearly 60% of men above 60 have some form of BPH. Approximately 35% of men with a family history of BPH are likely to develop the condition. While BPH can't be entirely prevented, a healthy diet and regular exercise can reduce the risk.

 

 

Are there any lifestyle changes or natural remedies that can alleviate the symptoms of an enlarged prostate?

A diet rich in fruits and vegetables can alleviate symptoms in about 25% of cases. Moderate exercise has shown a 20-30% reduction in BPH symptoms. Supplements like saw palmetto have shown promise but have yet to be proven effective.

 

 

Mr Edward Calleja is an esteemed urologist with more than 15 years of experience. You can Schedule an appointment with Mr Calleja on his Top Doctors profile.

By Mr Edward Calleja
Urology

Mr Edward Calleja is a leading consultant in urology and robotic pelvic surgery based in East Sussex at Sussex Premier Health, sub-specialising in pelvic uro-oncology. He has extensive experience with numeorus different urological conditions and procedures, with his areas of expertise including robotic prostatectomy, urinary tract infection, prostate cancer, enlarged prostate, bladder cancer, erectile dysfunction and prostatitis.  

Mr Calleja current practises privately at both Sussex Premier Health Eastbourne and Sussex Premier Health Hastings, where he has a special interest in robotic pelvis surgery. He also has extensive experience working in the NHS, where he currently holds the position of consultant urologist at East Sussex Healthcare NHS Trust.

Mr Calleja first qualified with an MD degree from the University of Malta in 2004. Since arriving in the UK, he has worked at some of the country's most prestigious hospitals. He has been awarded both an MRCS and FRCS from the Royal College of Surgeons. He is highly experienced in performing robotic surgery to treat various pelvic issues. He has been named a Prostate Cancer Clinical Champion by Prostate Cancer UK in recognition of his contributions to the treatment of the disease. He has developed a number of services for his urological cancer patients, such as active sureillance, preoperative optimisation and survivorship. 

In additional to his clinical work, Mr Calleja is also renowned for his contributions to medical research, with numerous articles published in peer-reviewed scientific journals.

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