Enlarged Prostate (BPH)

Signs & symptoms
As the prostate grows larger it can squeeze the urethra and block the normal flow of urine. When it becomes more difficult for the urine to flow freely, the bladder muscles work harder to force the urine through the narrowed urethra. This leads to the bladder wall becoming thicker and more sensitive, and makes it more difficult for the bladder to empty completely.

Not everyone with an enlarged prostate experiences symptoms. However, the following symptoms can occur:

• A feeling of not completely emptying your bladder
• Frequent urination
• Stopping and starting during urination
• Needing to urinate immediately when you get the urge
• Weak urine stream
• Having to push and strain to start urinating
• Getting up often at night to urinate

BPH can be irritating but it is not a life threatening condition.
In order to understand your treatment options, it helps to have an idea of how severe your symptoms are and how much they are affecting your life. A simple form such as the Prostate Symptom Score Sheet can help with this.

 

Complications

Urinary incontinence
Some men with BPH experience incontinence, which means that urine may leak out at times without their control. This may manifest as an urgent need to urinate before they are ready or it may be in the form of dribbling after they have finished.

Acute retention
This is the sudden inability to urinate despite having the urge to do so. It can be very painful and requires the insertion of a urinary catheter (tube) through the urethra in order to drain the urine from the bladder. You may be sent home with the catheter or be required to stay in hospital for a few days.

Other complications
Long term blockage of the bladder can cause:

• Weak bladder muscle
• Stones in the bladder
• Bladder infection or bleeding
• Severe blockage can also cause back pressure of urine on the kidney causing kidney disease or damage, although fortunately this complication is very rare.

Diagnostic Tests
Your urologist may ask you to get one or more of the following tests done as part of the diagnostic process:

• PSA (blood test to measure the prostate specific antigen) - this may be raised if your prostate is very enlarged. Flow rate and post-void residual - the patient is asked to urinate into a machine which measures the strength of the flow. A bladder ultrasound is then done to check that the bladder is emptying sufficiently.
• TRUS (trans rectal ultrasound) - this is used to measure the size of your prostate

If you're experiencing symptoms of an enlarged prostate, please call 020 7224 5089 or use the appointment form to book a consultation.