The prostate is located just below the bladder, where the urine flows through as the bladder is emptied. In most males the prostate increases gradually in size and over time. In some patients the enlargement of the prostate will eventually lead to obstruction and difficulty in emptying the bladder. This obstruction leads to symptoms which may include visiting the toilet often (frequency), a sense of urgency, getting up at night to empty the bladder (interruption of sleep), slow stream, straining to empty the bladder and interruption of the urinary stream whilst emptying the bladder. If the enlargement of the prostate is not treated, progressive obstruction could lead to complications like urine tract infections (UTI), blood in the urine (haematuria), bladder stones, thickening of the bladder wall (detrusor hypertrophy), the inability to empty bladder (urinary retention) or kidney damage (renal failure).

Investigations

When someone presents with symptoms or signs of BPH (enlargement of the prostate) investigations are aimed at diagnosing or confirming the obstruction to the bladder. These investigations may include urine tests, blood tests, an ultrasound or CT scan, a urinary flow test and in some patients a cystoscopy (small telescope placed in the urethra and bladder to inspect the prostate and bladder).

Treatment

In patients with mild to moderate symptoms and no complications, medical treatment (tablets) may improve the patient's symptoms and quality of life. In patients with moderate to severe symptoms or those that have experienced complications of BPH, surgery may be indicated.