Understanding the Importance of your Prostate

Many men do not understand what their prostate does and how it can impact their lives.  The prostate is a small gland that is about the size and shape of a walnut that is located below the neck of the bladder. The urethra runs through the center of your prostate, from the bladder through the penis, letting urine flow out of the body.

Your prostate is a male reproductive organ. The main function of your prostate is to produce prostatic fluid. The prostatic fluid is an alkaline fluid secreted by the prostate gland during ejaculation that forms part of the semen

Your prostate can become larger as you age, and usually begins to grow around the age of 40-50, this is a normal part of aging.  Eventually, this growth can lead to Benign Prostatic Hyperplasia, better known as BPH.     

What is Benign Prostatic Hyperplasia (BPH)? 

Benign prostatic hyperplasia, more commonly referred to as BPH or an enlarged prostate, is a non-cancerous enlargement of the prostate gland and its surrounding tissue. 

Affecting over 700 million men worldwide1,2, BPH is a common form of benign tumour found in men and is thought to come about as a result of hormonal changes that happen through ageing3

In this article, we will teach you all you need to know about BPH, highlighting not only what it is and how it’s diagnosed, but also how treatment approaches like the UroLift system can provide fast, effective relief to men living with symptoms of an enlarged prostate4,5.

An introduction to BPH

To fully understand what benign prostatic hyperplasia (BPH) is, we first need to take a more detailed look at the prostate. 

Located in men just below the bladder, the prostate is a walnut-shaped gland that has three main functions6: it plays a role in hormone production, helps regulate urine flow and ejaculatory processes, and produces seminal fluid — a key component of semen.  

During a man’s life, the prostate will go through two main growth periods. The first takes place relatively early on during puberty when the prostate almost doubles in size7. Then, from around the mid-twenties onwards, it carries on growing during the rest of an adult man’s life, ranging from anywhere between the size of a golf ball to as big as an orange7

BPH symptoms are brought on when the prostate gland grows too big. 

When this happens, the enlarged prostate can press on and block the urethra (the tube that enables urine to leave the bladder), squeezing it and causing the bladder wall to thicken over time. This can then bring on a wide range of bothersome urinary symptoms, as highlighted below. 

Understanding the symptoms of BPH

Having an enlarged prostate can cause a number of symptoms that impact your daily quality of life. In fact, BPH is one of the top ten leading reasons why men feel the need to visit a urologist8, with research finding that 1 in 4 men may suffer from BPH in their lifetime9.

These symptoms largely impact the urinary system and often include10,11

  • An urgent need to urinate
  • Difficulty starting your urine stream
  • Need to push or strain when urinating
  • Incomplete emptying (the sensation that the bladder isn’t empty after urinating)
  • Weak urine flow
  • Dribbling at the end or urination
  • Increased frequency of urination during the daytime
  • Frequent nighttime urination (known as nocturia)
  • A burning or painful sensation when urinating (known as dysuria)

BPH causes and risk factors

While the exact cause of BPH still remains relatively unknown, age and testicular factors are considered to be two key contributors12

Throughout life, men produce testosterone and a small amount of oestrogen. However, as men age, the ratio between the two hormones starts to falter – levels of active testosterone start to fall, resulting in a comparatively higher proportion of oestrogen in the blood12

Certain studies hypothesise that this relative increase in oestrogen levels stimulates certain growth-promoting substances within the prostate, leading to BPH13

Another theory suggests that high levels of dihydrotestosterone (DHT) – a male hormone that plays a role in prostate development – cause BPH. Researchers have shown, for example, that men who do not produce DHT also do not develop BPH12

Looking at age as a risk factor, the statistics below speak for themself. According to a study published in the Journal of Urology1:

  • Over 40% of men in their 50s have BPH
  • Over 70% of men in their 60s have BPH
  • Over 80% of men in their 70s have BPH
  • Nearly 90% of men in their 80s have BPH

Certain other risk factors can also increase the risk of developing the condition. These include: 

  • Family history – studies show that men with a family history of an enlarged prostate have an increased risk of developing signs and symptoms suggestive of BPH14.
  • Ethnicity – research has found that BPH risk can vary depending on your ethnic group. African-American men, for instance, are approximately 50% less likely to be diagnosed with BPH than Caucasian men15.
  • Lifestyle factors – certain lifestyle factors, such as smoking, obesity and lack of exercise, are all associated with an increased risk for BPH16.

Diagnosing BPH

If you are experiencing any symptoms of BPH that are affecting your overall quality of life, don’t worry — you’re not alone. 

Your first port of call should be arranging a consultation with your doctor. However, how urgently you should contact them will largely depend on the types of symptoms you have. 

When left untreated, BPH can pose a significant risk to bladder function over time. This is because the enlarged prostate can impact the urethra, resulting in lower urinary tract symptoms, urinary retention issues or infections due to incomplete bladder emptying3

If you encounter symptoms like these, or any other serious issues like blood in your urine or difficulties when urinating, you should consult a medical professional immediately. 

The initial GP consultation

During your consultation, your GP will ask a few questions about your symptoms and medical history, before conducting a few tests to determine whether your prostate gland is enlarged. According to the NHS, these tests might include: 

  • IPSS symptom score questionnaire – designed to measure how severe your urinary symptoms are by recording details related to how often they occur 
  • Blood tests – to assess your kidney function
  • Prostate-specific antigen (PSA) blood test – to measure the amount of PSA in your blood and screen for prostate cancer 
  • Urine tests – to check for abnormalities that could indicate an underlying condition
  • Digital rectal exam (DRE) – performed to feel the size and shape of your prostate gland through your rectum 

Referral to a urologist

Your doctor may refer you to a urologist for further evaluation of your BPH symptoms. This may be due to recurrent infections, previous treatment failure, kidney problems or having a raised PSA level.

When seeing a specialist, they will likely perform extra tests to determine the cause of your symptoms. These could include: 

  • Urodynamic testing– to measure nerve and muscle function, pressure around and in the bladder, flow rates and other factors17 
  • Transrectal ultrasound – to provide detailed images of the prostate that highlight its size, shape and structure 
  • PSA tests – to measure the amount of PSA in your blood and screen for prostate cancer
  • Cystoscopy – to evaluate the urethra and bladder, while also assessing whether the prostate is impacting the urethra12

Treatment options for BPH

There are several options available to treat BPH. However, finding the right treatment for you will depend on several aspects, such as the severity of your symptoms and the impact they have on your day-to-day life. 

Working together with your doctor, you will decide which type of treatment is best suited to your circumstances. 

If you only have mild symptoms, for instance, you might decide that you don’t need treatment at all. Whereas, if your symptoms are causing an increased number of bathroom visits throughout the day and night, a minimally invasive procedure like the UroLift System may be recommended. 

Active surveillance

During the initial consultation with your doctor, they may discuss taking more of a ‘watch and wait’-type approach if your BPH symptoms are mild to moderate. This will typically involve working with your doctor to monitor your prostate, usually through a yearly examination, without actively treating it.

Active surveillance may also involve making certain lifestyle changes, such as stopping smoking, exercising on a regular basis and maintaining a healthy diet that avoids high-fat, high-sugar and processed foods16

Medications

Certain types of medication may be prescribed to help you manage your symptoms of BPH and improve urinary flow issues. These will typically include18

  • Alpha-blockers – these relax the prostate’s muscles and help reduce urinary-related symptoms. However, they can also cause certain side effects, including dizziness, fatigue and ejaculation difficulties. 
  • 5-alpha reductase inhibitors – these increase urine flow and reduce the production of certain male sex hormones that contribute to the growth of the prostate. As a result, this causes the prostate to shrink in size, which can lead to side effects like erectile dysfunction, ejaculation problems and a reduced sex drive. 

Before taking any medication to treat your BPH symptoms, it's important to discuss any concerns you might have with your healthcare provider. They will be able to talk you through the potential side effects involved with each type of medication, while also making sure your treatment plan is best suited to your individual circumstances. 

By adhering to your doctor's prescribed medication regimen, this can then allow you to manage your symptoms more easily and may improve your overall quality of life. 

Minimally invasive procedures

As an alternative approach to taking medications, minimally invasive surgery can often be done as a same-day procedure with a much quicker recovery time than traditional surgery.  

Designed to offer relief from lower urinary tract symptoms due to BPH, these procedures are typically performed as an outpatient procedure using local anaesthetic. 

The UroLift system

A minimally invasive approach that your doctor could recommend is the UroLift system

Commonly performed under local anaesthesia as a same-day outpatient procedure19, this system works by using small implants to lift and hold enlarged prostate tissue away from the urethra, helping improve urine flow and reduce associated symptoms. 

A proven approach for patients looking for an alternative to medications or major surgery4, the UroLift System is the only enlarged prostate procedure that does not require heating, cutting, removing or destroying the prostate tissue.5

In the UK, the UroLift System is also recommended as part of the NICE guidelines for treating lower urinary tract symptoms of BPH20.

Surgical interventions

More invasive surgeries may require heating, cutting or removing excess prostate tissue. These will all typically be performed under general anaesthetic, require a hospital stay and could include surgeries like: 

  • Transurethral resection of the prostate (TURP)
  • Transurethral incision of the prostate (TUIP)
  • Prostatectomy
  • Laser surgery

Find a UroLift specialist 

If you are interested in finding out more information about the UroLift system, why not use our ‘Find a Physician’ service? This tool will help you find the closest hospital to you that offers this procedure on the NHS or privately. 

Alternatively, contact our team with any further questions or queries you might have and we’d be more than happy to help. 

Safety Statement

The UroLift System is indicated for the treatment of symptoms of an enlarged prostate up to 100cc in men 50 years or older. As with any medical procedure, individual results may vary. Most common side effects are temporary and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge.5 Rare side effects, including bleeding and infection, may lead to a serious outcome and may require intervention. Speak with your doctor to determine if you may be a candidate.

Please see the Instructions for Use for a complete listing of the indications, contraindications, warnings and precautions.

MCI 2023 0960

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The UroLift System