What it means
Benign prostatic hyperplasia, or BPH, is non-cancerous growth of the prostate. It can press on the urethra and make it harder for urine to flow. BPH is not cancer and does not itself increase the risk of prostate cancer. [1]
Symptoms to discuss
Symptoms may include a weak or interrupted stream, difficulty starting, a feeling that the bladder has not emptied, and frequent or night-time urination. Prostate size alone does not explain how troublesome symptoms are. Other conditions can also cause urinary symptoms. [2]
Seek immediate care if you cannot urinate. Fever with chills and urinary symptoms, severe pain or visible blood in the urine also need prompt assessment. Do not automatically attribute these changes to benign enlargement. [2]
What assessment may involve
The doctor reviews the effect on your daily life, your medical history and medicines. Depending on the circumstances, assessment may include an examination, urine tests, consideration of a PSA test, urine flow measurement or ultrasound. Not everyone needs every test. [3]
Options and differences between procedures
Mild symptoms may be managed with observation, reviews and changes in habits. Medicines or procedures may be considered in other circumstances. The decision depends on symptoms, complications and personal priorities. [3]
Procedure names describe different approaches: Rezūm uses water vapour; GreenLight photovaporisation uses a laser to vaporise tissue; HoLEP and ThuLEP separate obstructing tissue with holmium or thulium lasers. Adenomectomy, or simple prostatectomy, removes obstructing benign tissue and differs from radical prostatectomy for cancer. [4]
Before deciding, discuss expected relief, possible adverse effects and the potential need for further treatment. Ask how the proposed option may affect ejaculation, sexual function and urinary control. The availability and suitability of each technique are discussed during assessment. [1]
Prepare for the conversation
Bring previous test results and a list of medicines, including non-prescription products. Note which symptoms bother you most and when they occur.
- Have we established what is causing my symptoms?
- What benefit should treatment offer, and what would observation involve?
- Why might this option suit me?
- Will I need a catheter, and how will recovery be planned?