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Enlarged prostate

Information for men concerned about benign prostatic hyperplasia (BPH)

These pages are for men who want to know more about a non-cancerous enlargement of the prostate gland, called benign prostatic hyperplasia (BPH).

You may have been diagnosed with BPH or you may want to find out more about this common prostate problem.

These pages describe the causes, symptoms, diagnosis and treatment of BPH.

If you have any questions about anything you read on the website, you can call our confidential Helpline on 0800 074 8383.

You can also download and print a PDF version of the booklet.

What is benign prostatic hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is a common condition that affects many men from the age of about 50 years. About four out of every ten men (40 per cent) 1 over the age of 50 and three out of four men (75 per cent) 2 in their 70s have urinary symptoms that may be caused by BPH.

BPH is an increase in the number of non-cancerous cells in the prostate gland:

  • Benign – non-cancerous
  • Prostatic – to do with the prostate gland
  • Hyperplasia – an increase in the number of cells

BPH is not a form of cancer.

BPH causes your prostate gland to grow in size as you get older. In some cases if your prostate gets bigger it can cause the urethra to narrow and slow down the flow of urine.


BPH Diagram


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What causes BPH?

We do not yet fully understand what causes BPH. However, there are two risk factors that we do know about. These are:

Age

Your risk of getting BPH increases as you get older. Many men over the age of 50 will get an enlarged prostate gland but not all of these men will get symptoms.

Hormone levels

Changes in the balance of hormones in your body as you get older may cause cells in the prostate gland to grow.

Other factors

Some studies have also shown that obese men and men who have diabetes may be more at risk of BPH. You may be able to reduce your risk by doing more exercise and reducing the amount of alcohol you drink 3. However, we need more studies into the causes of BPH to know if, and how, we can prevent it.

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What are the symptoms?

Common symptoms of BPH include:

  • A weak urine flow
  • Needing to urinate more often, especially at night
  • A feeling that your bladder has not emptied properly
  • Difficulty starting to pass urine
  • Dribbling urine
  • Needing to rush to the toilet – you may occasionally leak urine before you get there

You may have only a few of these symptoms.

BPH is the most common cause of urinary symptoms in men as they get older. 4 Without treatment, some men may find that the symptoms of BPH slowly get worse 5. However, these symptoms can be caused by other medical problems that are not related to the prostate. They may also be caused by lifestyle factors and some medicines. You should visit your GP to find out what is causing the problem.

Am I more likely to get prostate cancer if I have BPH?

Having BPH does not put you at greater risk of getting prostate cancer. BPH and prostate cancer begin in different areas of the prostate gland and it is possible to have both BPH and prostate cancer at the same time. In most cases, early prostate cancer does not cause any urinary symptoms. Visit your GP if you are concerned about prostate cancer. You can also call our confidential Helpline on 0800 074 8383.

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How might BPH affect my life?

BPH affects men in different ways. Some men are able to cope with their symptoms well and do not need treatment. Other men find that having to stay near a toilet makes work, driving, being outdoors and attending social events very difficult.

For a few men, the symptoms of BPH may improve over time without treatment but for most men the symptoms will stay the same or will get worse. A small number of men may go on to develop acute or chronic retention of urine (see below). This is more likely if you are aged over 70, have a large prostate, a raised prostate specific antigen (PSA) blood test or have severe urinary symptoms 6,7 .

If you are diagnosed with BPH, the doctor at the hospital will look at your test results to see if you are at risk of these complications.

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Possible complications of BPH

Acute retention of urine

This is a sudden and painful inability to pass urine. Acute urine retention needs treating straight away, usually at a hospital. The bladder is drained using a tube that is passed through the penis into the bladder (catheter).

Chronic retention of urine

This develops more slowly than acute retention. You may feel that you are not emptying your bladder fully. The first signs for some men include leaking urine at night, wetting the bed or an expanding waistline. Chronic retention is usually painless but it means that you are not passing all of the urine in your bladder. Because of this your bladder slowly stretches, which can damage the bladder muscle. The urine left in your bladder may cause an infection or bladder stones. Without treatment, over a period of time, the build up of urine can overwork the kidneys and cause them to fail.

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How is BPH diagnosed?

There are several tests that your doctor can do to find out whether you have BPH. They will ask you about your symptoms, how long you have had them and whether they are getting worse over time. They will check whether your symptoms could be caused by another health problem, such as diabetes, or by any medicines you are taking, such as anti-depressants. Your lifestyle may also cause urinary symptoms, for example if you often drink a large amount of fluid or drink a lot of alcohol or caffeine.

Your GP may do some of these tests or you may need to visit a doctor who specialises in urinary problems (a urologist) or specialist nurse at the hospital. Ask your GP for more details about which tests you will have and what they involve. You can also call our confidential Helpline on 0800 074 8383. You may not have all of the following tests. If you are diagnosed with BPH, you may have some of these tests again after treatment to find out how well your treatment is working.

Urine test

You may be asked for a urine sample to check for any infection that could be causing you problems passing urine.

Blood tests

You may be offered a blood test to check that your kidneys are working properly. You may also have a prostate specific antigen (PSA) test.

PSA is a protein produced by cells in the prostate gland. BPH can cause the PSA level in your blood to rise. However, other factors, such as age, infection and prostate cancer may also affect your PSA level. You can find out more about the PSA test by reading our booklet, PSA and beyond: a guide for men concerned about prostate cancer.

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More information

The following organisations can give you support and information on BPH and other prostate problems:

www.medicines.org.uk
www.medicines.org.uk
Includes an A-Z of treatments and conditions and information on NHS health services in your local area.

NHS Choices
www.nhs.uk
For information on medicines, including details of how to get guides in large print, audio and Braille.

Patient UK
www.patient.co.uk
This website contains information that GPs use with their patients. Includes information on prostate problems.

Prostate UK
www.prostateuk.org
Telephone: 020 8788 7720

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Reviewed by:

  • Vanessa Basketter, Uro-oncology Nurse Specialist, Portsmouth Hospitals NHS Trust
  • Simon Bott, Consultant Urologist, Frimley Park Hospital, Frimley
  • Frank Chinegwundoh, Consultant Urological Surgeon, Barts and the London NHS Trust and Newham University Hospital NHS Trust
  • Jessica Hancox, Clinical Nurse Specialist for Urological Cancers, Chelsea and Westminster Hospital
  • David P Shipstone, Consultant Urological Surgeon, Chesterfield Royal Hospital
  • Andrew Ball, Hon. Consultant Urological Surgeon, Southend Hospital
  • The Prostate Cancer Charity Support & Information Specialist Nurses
  • The Prostate Cancer Charity Information Volunteers

Written and edited by:

The Prostate Cancer Charity Information Team

References used in the production of this page.

1 Trueman P, Hood SC, Nayak USL et al. Prevalence of lower urinary tract symptoms and self-reported diagnosed ‘benign prostatic hyperplasia’, and their effect on quality of life in a community-based survey of men in the UK. BJU Int 1999; 83: 410-415.
2 Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Journal of Urology 2005; 173: 1256-1261. 410-415.
3 Parsons JK. Modifiable risk factors for benign prostatic hyperplasia and lower urinary tract symptoms: new approaches to old problems. Journal of Urology. 2007; 101 (supp 3): 395-401.
4 Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.
5 Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.
6 Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Journal of Urology 2005; 173: 1256-1261.
7 Roehrborn CG. BPH progression: concept and key learning from MTOPS, ALTESS, COMBAT, and ALF-ONE. BJU International. 2008; 101 (supp 3): 17-21.

 

Page last updated: March 19th 2010