What is benign prostatic hypertrophy?

Benign prostatic hypertrophy (BPH) is a non-cancerous (benign) enlargement of your prostate. It's also known as 'benign prostate enlargement' or 'benign prostatic hyperplasia'.

The prostate is part of the male reproductive system. It sits under your bladder and wraps around the first part of your urethra. Your urethra is the tube that carries urine (wee) from your bladder through your penis to the outside.

If you have BPH, your prostate can press on or block your urethra. This causes problems with urination (doing a wee).

BPH gets more common with age, affecting about 50% of males aged in their 50s and 80% of males aged in their 80s.

What are the symptoms of benign prostatic hypertrophy?

BPH can cause problems with urinating, because the enlarged prostate squeezes and narrows the urethra.

Symptoms of BPH can include:

• difficulty getting started when doing a wee
• straining to urinate
• poor urine flow or a weak stream
• a stream that may stop and start
• dribbling at the end of urinating
• not being able to completely empty your bladder

Other symptoms include:

• getting up at night to pass urine
• an urgent need to pass urine
• passing urine more often than usual

These symptoms may interfere with your daily activities and cause you distress.

What causes benign prostatic hypertrophy?

The exact cause of BPH is not clear. It's thought to be connected to changes in your hormone levels as you get older.

Your risk of BPH is higher if you:

• are older than 50 years
• have a family history of BPH

There may be a link with BPH and:

• smoking
• male pattern baldness
• metabolic syndrome

When should I see my doctor?

See your doctor if you are having trouble with urination or bladder control.

Your doctor can check whether your symptoms are due to BPH or another cause. They can also give you advice about what you can do to relieve your symptoms.

It's especially important to see your doctor if:

• you are unable to pass urine
• there is blood in your urine
• you have symptoms of a urinary tract infection
• you or your relatives have had prostate cancer

How is benign prostatic hypertrophy diagnosed?

Your doctor will ask about your symptoms and how long you have had them. They will want to know about:

• your overall health
• any medicines you are taking
• how much your symptoms are impacting your life

Your doctor will also examine you. This may include a digital rectal examination, which involves your doctor placing a gloved finger into your rectum (back passage). During this examination, your doctor can feel the size and shape of your prostate.

Your doctor may recommend tests, such as:

• blood tests
• urine tests
• an ultrasound scan of your prostate, bladder and kidneys

Your doctor might refer you to a urologist (specialist in the urinary system and male reproductive organs). They may do more tests and recommend treatment.

How is benign prostatic hypertrophy treated?

The aim of treatment is to relieve your symptoms. Treatment usually depends on:

• how much your symptoms are bothering you
• if your symptoms are affecting your wellbeing and quality of life
• whether you have any complications

Your doctor should discuss the BPH treatment options with you and ask about your preferences. You can discuss which treatment is most suitable for you.

Self-care and lifestyle measures

If your symptoms are mild, self-care measures may help. These can include:

• cutting down on caffeine and alcohol
• not drinking fluids in the evening
• avoiding spicy or acidic foods (which can irritate your bladder)
• avoiding or treating constipation
• doing pelvic floor exercises
• bladder training

Your doctor may refer you to a specialist physiotherapist to help with bladder training and pelvic floor exercises.

Your doctor may recommend changes to your usual medicines if they could be aggravating your BPH symptoms. Do not change or stop your medicines without talking to your doctor or pharmacist.

Medicines for benign prostatic hypertrophy

If your symptoms are more troublesome, there are prescription medicines that can help. You may need to take a combination of medicines.

There are side effects with most medicines. Some of the side effects of BPH medicines can include:

• problems with libido, erections or ejaculation
• nasal congestion (blocked nose)
• low blood pressure
• dizziness

Talk to your doctor or pharmacist if you are worried about side effects from your medicines.

Surgery for benign prostatic hypertrophy

Surgery may be recommended if:

• other treatments are not controlling your symptoms
• other treatments are not suitable
• you have complications

Some of the procedures used to treat BPH include:

• transurethral resection of the prostate (TURP)
• transurethral incision of the prostate (TUIP)
• laser therapy
• other less-invasive procedures

You can talk to your urologist about the most suitable options for you. You should also ask them about side effects of the different types of surgery.

What are the complications of benign prostatic hypertrophy?

If BPH is not treated, it can lead to other problems, including:

• urinary retention
• urinary tract infections
• bladder stones
• an overactive bladder

Having BPH does not increase your risk of developing prostate cancer.

Can benign prostatic hypertrophy be prevented?

BPH is more common as you get older. You may be able to delay the onset of BPH by:

• getting plenty of exercise
• maintaining a healthy weight
• limiting the amount of alcohol you drink

Resources and support

If you are concerned about symptoms of BPH, talk to your doctor.

Continence Health Australia has information on prostate problems, including in languages other than English.

Healthy Male has information on prostate enlargement.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.