Prostate health
3. Benign prostatic hyperplasia
Men's prostate glands gradually get larger as they get older. Because the prostate is wrapped around the tube that carries urine out of the bladder, when the prostate gets bigger it can restrict the flow of urine. One in five men in their fifties will have symptoms of benign prostatic hyperplasia.
It's important to stress that the increase in size of the prostate has nothing to do with cancer. There is no link between an enlarged or enlarging prostate and the risk of prostate cancer: they are two separate conditions.
It is not clear why the prostate gets larger and there are no known ways of preventing it. It starts getting larger when you are in your 30s but you probably won't notice any effects until you are in your 50s or 60s.
Research has shown that men who are more physically active are less likely to have symptoms of BPH. One study showed that men who exercised by walking two to three hours per week had a 25 per cent lower risk of BPH compared with men who didn't walk for exercise.
Symptoms of BPH
All of the symptoms of BPH are linked to urinating. They include:
- Having to strain to urinate;
- A hesitant start to urinating;
- Needing to urinate frequently – including at night;
- Feeling a sudden, almost irresistible need to urinate; and
- Having a weak stream particularly when starting or stopping urinating.
Symptoms can be made worse if you are taking other medications such as 'over the counter' cold and flu remedies, some anti-depressants and antihistamines. Being immobile and drinking too much fluid can also make the symptoms worse.
Although there is no link between BPH and prostate cancer, the symptoms can be similar. It's therefore important to get a diagnosis as soon as possible.
Treatment of BPH
Benign prostatic hyperplasia can be treated by drugs or by surgery. There is also evidence that some herbal treatments can be effective for people with mild symptoms. If left untreated BPH can lead to kidney damage or the sudden and complete inability to pass urine.
Drug treatments
Drugs called alpha-blockers are usually the first choice for treating BPH. They relax the muscle in the prostate, which means that urine can pass more freely through the urethra. Drugs known as 5a-reductase inhibitors can help to shrink an enlarged prostate gland. The brand names for these drugs are finasteride and dutasteride.
As with all drugs these treatments can have side-effects.
Surgery
Surgery has become less common since the introduction of effective drugs for BPH.
Surgery is more effective at relieving symptoms but can lead to complications.
