Enlarged Prostate (BPH): Symptoms, Diagnosis and Treatment Options

What Is BPH?

Benign prostatic hyperplasia (BPH), commonly called an enlarged prostate, is a non-cancerous growth of the prostate gland that becomes increasingly common with age. As the prostate enlarges, it can press on the urethra and slow the flow of urine. BPH is not cancer, though the two conditions can occasionally coexist, which is why evaluation matters.

Common Symptoms

• A weak or interrupted urine stream
• Difficulty starting urination (hesitancy)
• Straining to urinate
• Frequent urination, especially at night (nocturia)
• A sense of incomplete bladder emptying

What Causes the Prostate to Enlarge?

Age-related hormonal changes involving testosterone and its byproduct DHT are the primary driver of prostate growth. Genetics, obesity, and diabetes can also play a contributing role.

Diagnosis

A typical work-up includes a symptom questionnaire, a physical prostate exam, a PSA blood test, a urine flow test, and an ultrasound to assess prostate size and how well the bladder is emptying.

Treatment Options

Mild symptoms are often simply monitored. Moderate symptoms usually respond well to medication that relaxes the prostate and bladder neck or shrinks the gland over time. When symptoms are more severe, or medication isn't enough, minimally invasive procedures come into play. TURP (transurethral resection of the prostate) is a well-established surgical option performed through the urethra, without any external incision. HoLEP (Holmium/Thulium laser enucleation of the prostate) is a more modern laser-based technique that's often preferred for larger prostates, generally with less bleeding and a shorter catheterization period.

What Happens If BPH Is Left Untreated?

Untreated BPH can progress to bladder stones, recurrent urinary infections, urinary retention, and, in severe long-standing cases, back-pressure damage to the kidneys — which is why persistent symptoms shouldn't be ignored.

When to Consult Dr. Raju R

If you're noticing a weaker stream, more frequent night-time trips to the bathroom, or straining to urinate, an evaluation can clarify whether it's BPH and which treatment path fits best. Dr. Raju R offers medical management as well as TURP and HoLEP at Genesiss Multi-Speciality Hospital, Bangalore.