Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, a common condition affecting older men that can obstruct the flow of urine. It becomes increasingly common with age, affecting more than half of men over 60 and up to 90% of men in their 80s. While not life-threatening and not linked to prostate cancer, BPH can significantly affect quality of life and, if left unmanaged, can lead to urinary complications.

• Weak or slow urine stream • Difficulty starting urination • Frequent urination, especially at night (nocturia) • A sudden, urgent need to urinate • Straining to urinate • A feeling that the bladder is not fully empty after urinating • Dribbling at the end of urination • Interrupted or stop-start urine flow

BPH results from age-related hormonal changes that cause the cells of the prostate gland to multiply, enlarging the gland. As the prostate surrounds the urethra (the tube that carries urine from the bladder), this enlargement can compress it and obstruct urine flow. The exact triggers are not fully understood but are linked to changes in testosterone and other hormone levels with age.

• Age: risk rises significantly after age 40 and continues increasing with age • Family history of BPH • Obesity • Diabetes and heart disease • Sedentary lifestyle • Erectile dysfunction, which often coexists with BPH

Untreated or poorly managed BPH can lead to: • Acute urinary retention, requiring emergency catheterisation • Recurrent urinary tract infections • Bladder stones • Bladder damage from long-term straining • Kidney damage from back-pressure on the kidneys (in severe, prolonged cases) • Blood in the urine

BPH cannot be entirely prevented, as it is closely linked to normal ageing, but the following may help manage symptoms and reduce risk: • Maintain a healthy weight and stay physically active • Limit fluids, caffeine, and alcohol in the evening to reduce night-time urination • Avoid over-the-counter decongestants and antihistamines, which can worsen symptoms • Urinate when you first feel the urge, rather than holding it in • Attend regular health check-ups after age 40, including prostate assessment • Manage related conditions such as diabetes and obesity