What is benign prostatic enlargement?

Benign prostatic enlargement occurs when the size of the prostate gland increases due to a hormonal imbalance in men. The prostate is the male sex gland that surrounds the urethra. It is located below the bladder and above the rectum, and is responsible for producing seminal fluid. Prostatic hyperplasia is a common pathology in men over the age of 50, and can adversely affect their quality of life.

What is the prognosis of benign prostatic enlargement?

Benign prostatic hyperplasia, or enlargement of the prostate gland, is a common pathology in men after middle age. It is not serious, nor does it increase the risk of cancer, which can also affect this gland.

The main problem with benign prostatic enlargement is that its symptomatology is bothersome for the sufferer, and can even be incapacitating. However, the prognosis of this pathology is positive with prompt and adequate treatment, although it may return over time. Each case of hyperplasia will require necessary and regular follow-ups with the urologist.

What are the symptoms of benign prostatic enlargement?

The symptoms, which appear progressively, include:

• urinary incontinence
• difficulty urinating
• urinating more frequently
• urinary urgency
• dribbling after urination
• need to urinate several times a night
• pain when urinating
• blood in the urine

In severe cases, benign prostate enlargement can lead to an absolute inability to urinate, urinary tract infections, or impaired kidney function.

How is benign prostatic enlargement diagnosed?

If one or more of the above symptoms are present, the urologist will assess the person’s medical history, study the severity of their symptoms and perform a rectal examination to check the condition of the prostate.

The person may also require clinical tests such as urine tests to rule out infection, or blood tests to examine prostate-specific antigen (PSA) levels and to rule out prostate cancer.

What causes benign prostatic enlargement?

Although there is no known direct cause or risk factor for benign prostatic enlargement, it occurs when the size of the prostate gland increases due to a hormonal imbalance in the testicles: the female hormone (oestrogen) increases, while the male hormone (testosterone) decreases.

Can it be prevented?

Benign prostatic enlargement cannot be prevented, but it can be detected in its early stage through regular check-ups with a urologist.

Specialists recommend annual prostate screening after the age of 50 when there is an increased risk of prostate enlargement.

How is benign prostatic enlargement treated?

If symptoms are mild, the specialist may prescribe medication and recommend lifestyle changes (such as avoiding alcohol and caffeine, playing sports, and adapting urination routines). In more severe cases, surgery may be required.

Operations for benign prostatic hyperplasia usually include:

• Transurethral resection of the prostate: This is the most common procedure, in which the prostate is removed through an endoscope inserted through the penis.
• Simple prostatectomy: The inside of the prostate is removed through an incision made in the abdomen.
• Prostate laser surgery: With this latest technique, the tissue is destroyed with a laser, making it a less invasive option.

Which specialist treats benign prostatic enlargement?

A urologist is the specialist in charge of treating benign prostate enlargement.

When does the condition typically start to develop?

The condition, more often than not, typically starts to develop in a man's thirties, with symptoms generally being experienced when they are into their fifties. 

Is benign prostatic enlargement life-threatening?

Thankfully, no. Benign prostatic hyperplasia is nor cancerous nor life-threatening. 

What can happen if it is left untreated?

If left untreated, patients could be at a high risk of developing and suffering from some or all of the following medical conditions: 

• urinary tract infections
• kidney stones
• blood in the urine
• urinary incontinence
• kidney and/or bladder damage

Will I need a catheter after treatment for benign prostatic enlargement?

Whilst it is not a must, the majority of patients will be recommended to have a catheter inserted for a couple of days after treatment (especially surgical procedures) in order to help with urination.