What is BPH?
BPH, or benign prostatic hyperplasia, is a slowly occurring enlargement of the prostate gland in men. It usually occurs to men over the age of 50.
How would I know if I have BPH?
Men usually come to see a doctor when they have problems with passing urine.
These can include:
- Slow urinary stream
- A feeling that the bladder doesn’t finish emptying
- Frequent need to pass urine
- Problems with having to wait before starting to pee
- An urgent need to urinate and having to plan journeys and trips out
- A urine stream that starts and stops
- Getting up excessively at night to pee
Alastair Henderson is a specialist in the urinary tract including the bladder and prostate who is expert in sorting out these sort of problems.
How is BPH diagnosed?
Alastair will usually want to meet for an appointment. Men may need to make sure prostate cancer is not a concern by doing a prostate examination, which involves inserting a gloved finger through the rectum to examine the prostate directly. A blood test called PSA would also be done if your GP has not already checked this.
Is BPH the same as prostate cancer?
No. The two conditions are different and having an enlarged prostate does not raise a man’s risk of developing prostate cancer but symptoms can be similar.
If initial tests suggest prostate cancer an MRI and biopsy of the prostate can be used to tell which condition you have. Effective treatment is available for most prostate cancer patients.
Will I need any special tests?
For most patients a flow test where you pass urine into a machine to measure the speed or urine flow is usually done along with an ultrasound scan to check the bladder empties completely after passing water. Some men might need an ultrasound of the prostate or a telescope test before some treatments. The Spire Tunbridge Wells has excellent facilities to complete these tests quickly and easily.
How is BPH treated?
If a man has mild prostate enlargement, and few symptoms it may be appropriate to give advice only and wait until he needs treatment. Men are often keen to be reassured simply that the symptoms they have are not of other serious conditions like prostate or bladder cancer.
If treatment is needed it may be that the most helpful methods can be:
- Tablet treatment to relax or shrink the prostate or to help with an overactive bladder
- Urolift® minimally invasive implant
- Laser surgery (Holmium Laser Enucleation of the Prostate – HOLEP)
All of these treatments have been assessed by the National Institute if Clinical Excellence as effective treatments for BPH https://www.nice.org.uk/.
Who can receive medication?
If symptoms are mild medication may be very effective in the short term (up to several years) but may not be suitable if symptoms are severe and tablets may not be effective in the long term if the prostate continues to enlarge.
What is a prostatic urethral lift (Urolift®) procedure?
A prostatic urethral lift is a minimally-invasive procedure that can help relieve urination problems caused by an enlarged prostate (also called benign prostatic hyperplasia or BPH).
It is performed as a day visit procedure in suitable men and doesn’t usually require a catheter tube to be inserted after surgery. The procedure can be done under local anaesthetic with sedation to keep the patient sleepy and has been shown to have good results for suitable patients.
It can have fewer sexual side effects such as reduced ejaculation or sexual performance than some traditional tablet treatments or surgery.
What about men who are not suitable for Urolift® ?
Men with worse symptoms or who have had an episode where a stoppage has occurred and they cannot pass water may require other sorts of surgery.
Holmium Laser Surgey for BPH (HoLEP)
Surgery is often best for men who have moderate to severe problems and haven’t had success with other treatments, such as medications. Men having surgery are given general anaesthesia and are in the hospital for at least one night. Tissue is removed which comes from inside the prostate gland – the area that is pressing on the urethra.
Traditional electrical surgery (TURP) has largely been replaced at Spire Tunbridge Wells by LASER surgery using HoLEP. This usually means that the patient can go home quicker than with traditional surgery, usually staying just one night in hospital with very good durable results for treatment.
When can I make an appointment?
Alastair does a private clinic twice per week at Spire Hospital Tunbridge wells and appointments are available by contacting his secretary Joy Evans on 01892740037 or via email on Joy.EVANS@spirehealthcare.com