Benign prostate enlargement (benign prostatic hyperplasia, BPH) is the most common disease of the prostate. From the age of around 50, practically one in two men are affected, but not all of them have symptoms. Benign prostate enlargement is usually treated with medication. In most cases, benign prostate enlargement is harmless. If there is an accumulation of urine in the bladder, surgical removal of the prostate may be necessary.


How does prostate enlargement develop?

The prostate (prostate gland) is located below the bladder and surrounds the urethra. The gland produces a secretion that is expelled together with sperm during ejaculation. As men grow older, their prostate often becomes enlarged. Hereditary predisposition, the male sex hormone and age in particular part in the occurrence of this enlargement. Thus, around 40% of men are affected by prostate enlargement by the age of 50 years; at the age of 80 years old, the figure even rises to more than 90%.

How does an enlarged prostate become noticeable?

The symptoms vary, depending on how extensive the prostate enlargement is and the extent to which it prevents the urine from flowing out through the urethra. Many patients suffer more or less from the following symptoms:

  • Weakened urine stream
  • Increased urge to urinate
  • Urination at night (nocturia)
  • Strong urge to urinate
  • Urine dribbling after emptying the bladder
  • Feeling of incomplete bladder emptying

In rare cases, complete urinary retention can occur, in which case surgical intervention is necessary. An enlarged prostate may also be the reason for blood in the urine. Blood in the urine should always be checked by a doctor, as cancer can also be behind it. The impaired urine flow caused by prostate enlargement also facilitates the occurrence of urinary tract infections and bladder infections.

How do you recognise benign prostate enlargement?

Benign prostate enlargement is diagnosed on the basis of the symptoms, the patient's medical history and with the help of examinations. The enlarged prostate can be palpated via the rectum (digital-rectal examination). The exact size of the prostate can be determined with an ultrasound examination. Blood tests and urine tests provide further information on prostate enlargement. A prostate biopsy can be carried out if the patient has suspected prostate cancer.

What are the treatment options?

The treatment depends on the severity of the symptoms and the extent of the impact. Treatment is often not necessary for minor complaints. If the symptoms are too troublesome or the suffering is greater, the symptoms of prostate enlargement can be treated with medication. Herbal medicines and medicines that block the effect of the sex hormones on the prostate are available for drug treatment.

If urination is severely impacted and the patient is suffering from complete urine retention or repeated bladder infections, surgery may be necessary. Thanks to modern, minimally invasive methods, complaints such as erectile dysfunction and incontinence are rare after surgery. Read more about the surgical procedures in the chapter on prostate surgery.

Alleviation of prostate issues

Discomfort due to prostate enlargement can be alleviated to a certain extent with an active lifestyle and a balanced diet.

  • Eat a wholesome, balanced diet
  • Avoid sitting for long periods
  • Exercise regularly
  • Drink between 1.5 and 2 litres of tea, water or juice spritzers daily
  • Enjoy only small amounts of alcohol and strong coffee
  • An active love life can have a positive effect on prostate problems

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