Benign means non-cancerous. Many things, including prostate cancer and prostatitis can cause an enlarged prostate. This factsheet is just about enlarged prostate caused by BPH.
The prostate is a gland that produces the liquid part of semen (the fluid produced when you ejaculate). It’s about the size of a walnut and lies at the base of your bladder.
The front of your prostate surrounds your urethra – the tube that carries urine from your bladder and out through your penis. Any change in the size or shape of your prostate can narrow this tube, making it difficult for you to pass urine.
If you have BPH, a rapid growth in the cells in your prostate can lead to growth of your prostate gland. Not all men with BPH will develop an enlarged prostate.
If you have an enlarged prostate you may get symptoms such as:
If you have any of these symptoms, see your GP.
In some men, enlarged prostate can lead to more serious problems, such as the following.
The exact reasons why some men develop BPH and an enlarged prostate are not fully understood at present. However, the main risk factor is age. Nearly a third of men over the age of 50 are thought to have symptoms caused by an enlarged prostate.
Your GP will ask you about your symptoms and examine you. He or she may ask you to complete a questionnaire to assess how severe your symptoms are and how much they are bothering you.
Your GP will feel your abdomen to check whether your bladder is swollen. Your GP may suggest the following tests to rule out prostate cancer as a cause of your symptoms.
Your GP may also ask you for a urine sample and blood tests to check for urinary tract infections and check how well your kidneys are working.
Your GP may refer you to a urologist (a doctor who specialises in identifying and treating conditions that affect the urinary system) if there are any doubts about your diagnosis, or if you need surgery. The urologist may advise the following tests.
There are various treatments available for enlarged prostate. Your treatment will depend on a number of factors, including your age, your general health and the type of symptoms you have.
If you have mild to moderate symptoms that aren't bothering you much, your GP may suggest you don’t have any immediate medical treatment, but just monitor your condition with routine check-ups. Your GP may give you some advice on simple lifestyle changes you can make to improve your symptoms, such as cutting down on caffeine and alcohol and reducing the amount of fluid you drink in the evening.
He or she may also suggest a programme of exercises known as bladder training. This involves increasing how much urine your bladder can hold by trying to increase the amount of time before you need to urinate. Only do this if you are advised by your GP.
If your symptoms are bothering you, your GP may suggest treatment with one or a combination of the following medicines.
These include alfuzosin, doxazosin and tamsulosin. Alpha-blockers work by relaxing the muscles at the neck of your bladder, reducing the pressure on your urethra and increasing the flow of urine. They don’t cure BPH but may help to alleviate some of your symptoms. Alpha-blockers can be associated with side-effects such as dizziness and light-headedness, as a result of low blood pressure. Your GP can prescribe alpha-blockers. You can also buy tamsulosin from a pharmacist.
5-alpha reductase inhibitors
If you have a particularly large prostate or a high PSA level (but don’t have any signs of prostate cancer), your GP may prescribe you a 5-alpha reductase inhibitor, such as finasteride or dutasteride. These medicines work by blocking the production of a hormone called dihydrotestosterone, which can reduce the size of your prostate. They can take six months or more to work.
The most common side-effects of 5-alpha reductase inhibitors are sexual problems, including a reduced sex drive, difficulty in maintaining an erection and problems with ejaculation. However, these problems seem to affect more men during the first year of treatment and become less common as treatment continues.
If medicines don’t help to improve your symptoms, or if you have complications or your symptoms are particularly severe, your GP may refer you to a urologist for further treatment. He or she may suggest one of the following types of surgery.
New treatments, such as botulinum toxin injections, laser vaporisation techniques and laparoscopic prostatectomy are under development. You may be offered a new technique as part of a clinical trial. Ask your surgeon for more details.
There have been claims that a number of plant extracts, such as saw palmetto, are effective at treating symptoms of enlarged prostate. However, there is no good quality evidence to support these claims. In addition, these therapies are not regulated, so effective dosages and risk of side-effects are uncertain.
If you do choose to try herbal medicines, talk to your GP first.
No, there is no evidence to show that your risk of prostate cancer is increased if you have an enlarged prostate caused by benign prostatic hyperplasia (BPH).
Some of the symptoms of enlarged prostate can be very similar to those of prostate cancer, so it can be easy to think that the two are linked. However, an enlarged prostate as a result of BPH is caused by an increase in the number of benign (non-cancerous) cells in the prostate gland. It is not a form of cancer.
Although you can develop prostate cancer if you have BPH, there is no evidence to show that you're any more likely to than someone who doesn’t have BPH.
It’s impossible to say for certain whether your symptoms will get worse without treatment, as everyone’s condition progresses differently.
About three to four in 10 men with symptoms of benign enlarged prostate find their condition doesn't get any worse with time. However, in general, most men’s symptoms do progress very slowly over time. Self-help measures, such as reducing your caffeine intake and the amount of fluid you drink in the evening, and bladder training, may help to improve your symptoms.
If your symptoms aren't too troublesome, you may decide not to have any treatment for now. If you find your symptoms do progress or self-help measures aren't helping, you can go back to see your GP and discuss your treatment options.
You may be able to reduce your risk by being more physically active. However, more research is needed to say for sure.
The exact reasons why some men develop BPH and an enlarged prostate aren’t fully understood at present. However, age is known to be a key risk factor, and genetics may also play a part.
Some studies have suggested that being more physically active may be associated with a reduced risk of developing an enlarged prostate. However, more research needs to be done to say for certain whether there is a direct link between the amount of exercise you do and risk of prostate problems. No matter what, being physically active is an important part of a healthy lifestyle and can help to reduce your risk of numerous other conditions, such as heart disease, stroke and cancer. So it's always worth trying to keep active.