By Dr. Ayush Khetarpal | Urologist, Khetarpal Hospital

A Common Concern, Often Quietly Endured

It usually starts gradually. A slower stream. A lingering sense that the bladder hasn’t fully emptied. An extra trip or two to the washroom during the night. Many men chalk it up to age, silently adjusting their routines without ever seeking help.

But these subtle changes are often signs of Benign Prostatic Hyperplasia, or BPH, a non-cancerous enlargement of the prostate gland that affects over 50% of men above the age of 50. By age 80, nearly 9 out of 10 men will experience some symptoms of BPH. The good news? It’s manageable, and in many cases, highly treatable.

What Is BPH and Why Does It Happen?

The prostate gland, located just below the bladder and surrounding the urethra, plays a role in producing seminal fluid. As men age, the prostate often begins to enlarge, a natural process believed to be influenced by hormonal changes, particularly a shift in testosterone and estrogen levels.

As the prostate grows, it can start compressing the urethra, the narrow tube that carries urine from the bladder out of the body. This pressure obstructs urine flow and leads to the classic symptoms of BPH.

Recognising the Symptoms

Men with BPH often describe symptoms that gradually intensify over months or even years. These may include:

• A weak or interrupted urine stream
• Difficulty starting urination
• A feeling that the bladder doesn’t empty completely
• Increased frequency of urination, especially at night (nocturia)
• Urgency or a sudden, uncontrollable urge to urinate
• In some cases, dribbling after urination or straining to void

While these symptoms can significantly impact quality of life, they’re also frequently underreported, often out of embarrassment or the belief that “this is just part of getting older.”

Why It’s Important to Seek Medical Advice

Although BPH itself is not cancerous, ignoring the symptoms can lead to complications such as urinary tract infections, bladder stones, acute urinary retention (sudden inability to urinate), or long-term bladder damage. These risks make early evaluation essential, not only for comfort, but for preserving urinary function.

At Khetarpal Hospital, we approach BPH with a focus on both medical accuracy and patient comfort. Our priority is to understand each individual’s symptoms, concerns, and goals before recommending any intervention.

How Is BPH Diagnosed?

Evaluation begins with a detailed discussion of symptoms, followed by:

• Physical examination, including a digital rectal exam (DRE) to assess prostate size
• Urine flow tests and bladder scans to measure residual urine
• PSA (Prostate-Specific Antigen) blood test to rule out prostate cancer
• Ultrasound or urodynamic studies, if needed, for further insight

Each of these steps helps us confirm the diagnosis and tailor the most appropriate treatment plan.

What Are the Treatment Options?

BPH does not always require surgery. Many patients respond well to lifestyle changes and medications that relax the prostate and bladder muscles or reduce prostate size.

If symptoms are moderate to severe or not relieved by medication, we may explore minimally invasive procedures. These include:

• TURP (Transurethral Resection of the Prostate) – a common surgical option that removes part of the prostate tissue
• Laser therapy – which vaporizes or enucleates the excess tissue with minimal bleeding
• Prostatic Urethral Lift (PUL) or REZUM water vapor therapy, both of which are newer, less invasive options that preserve sexual function and recovery time

Our aim is always to recommend the least invasive, most effective option based on the patient’s age, prostate size, lifestyle, and medical history.

Addressing BPH Before It Escalates

Benign Prostatic Hyperplasia is common, but that doesn’t mean it should be ignored. If you find yourself planning your day around the nearest washroom or waking up several times at night, don’t wait for the symptoms to worsen.

Effective solutions exist, and timely treatment can restore not just urinary comfort, but overall quality of life.