BENIGN PROSTATIC HYPERTROPHY

What is it?

The prostate is an internal gland in men between the bottom of the bladder and the top of the penis. The urethra, the tube through which urine passes down from the bladder when you pass water, runs through the middle of it. Benign prostatic hypertrophy is a swelling of this gland. It is not cancerous. Because the prostate surrounds the urethra, when it swells it can block the flow of water.

What causes it?

There is no special cause for this condition. It just sometimes happens as you get older.

Who gets it?

Since only men have prostate glands, only men can get this condition. The single big risk factor is age - the older you are, the more likely you are to suffer from it. It is unlikely to start before 45.

What are the symptoms?

You will notice first that your stream of urine is not as strong as it used to be - that is, you could not 'pee over a five-bar gate' if you wanted to. You may need to pass water more often, and could find yourself getting up several times in the night to do so. You may find that when you want to pass water, you feel you have to rush to get to the toilet in case you cannot wait Once you get there, however, you may have to wait some time for the stream to come. You may have dribbling at the end of the stream. It can sometimes cause urine infections, which can cause intense burning and stinging on passing water.

When should I go to my GP?

You will often find that these symptoms come on gradually. Once they are getting troublesome, make a routine appointment with your GP to discuss them. It is not something you should ignore completely, though, because if it is left for too long it can sometimes affect the kidneys.

What tests will my Doctor want to do?

Your GP will probably feel your stomach and may want to put a finger into the back passage to feel the prostate through the wall of the back passage canal. He or she may also do a blood test.

What is the short-term treatment?

If the symptoms are bad enough it may need medication or an operation. Very occasionally, the prostate blocks the stream of urine completely, causing a very painful build-up of urine in the bladder - this is called acute retention of urine. The short-term treatment for this is to pass a catheter down the penis into the bladder using local anaesthetic jelly, to relieve the blockage.

Will I need long-term treatment?

You may need to have an operation to cut away the extra prostate tissue and clear the passage from the bladder. Some people who are not fit for surgery or who do not want an operation are sometimes treated with tablets, although these have to be taken for a long time to yield any benefit.

How can I stop it getting worse?

Try not to hold your water for long periods, as this can cause complete blockage of the water stream.

Will I need regular check-ups?

No. But you need to see your GP again if symptoms get bad enough to be a real nuisance, or if you get complications such as an infection.

Will I need to go to hospital?

Sooner or later you are likely to need some sort of operation. How quickly your GP refers you for this will depend on how bad your symptoms are and what your GP finds during the examination.