What BPH Is
BPH means the prostate has grown larger. It is not cancer, and it does not turn into cancer. But the prostate sits around the urine pipe, so as it grows it squeezes that pipe and slows the flow. About half of men over 50 have it, and most men over 80. Left alone for years it can harm the bladder or the kidneys.
Symptoms
They come in two groups.
- Blocked flow: Weak or stop-start stream, waiting for it to begin, straining, dribbling at the end, and feeling not quite empty.
- Bladder irritation: Going every hour or two, a sudden urge, and getting up twice or more at night.
How Bad Is It?
The IPSS is a seven-question form you fill in yourself. It turns your symptoms into a score, which helps decide what to do.
| IPSS score | Severity | Usual approach |
|---|---|---|
| 0–7 | Mild | Watch and wait. Change habits |
| 8–19 | Moderate | Tablets |
| 20–35 | Severe | Consider an operation |
The score covers symptoms only. How much they bother you counts just as much.
The Tests
- Flow test: Measures how fast the stream is.
- Residual urine: An ultrasound to see how much is left after you go.
- PSA blood test: Checks for prostate cancer alongside the enlargement.
- Prostate size on ultrasound: Helps pick the right tablet or operation.
Treatment
- Habits: Drink less in the evening, cut tea, coffee and alcohol, and try again a few seconds after you finish.
- Alpha-blockers (tamsulosin, silodosin) — relax the muscle at the outlet. Flow improves within days.
- Finasteride or dutasteride: Shrink the gland over six to twelve months. Best for larger prostates.
- Both together: For a large gland with troublesome symptoms.
- Laser: Removes the blocking tissue through the urine pipe. An option for men on blood thinners.
- TURP: The long-established operation, through the urine pipe, with no cut on the body.
You cannot pass urine at all. There is blood in the urine. You keep getting urine infections. Or a blood test shows your kidney function has dropped. Watching and waiting is no longer the right approach once any of these appear.
A short consultation can work out your IPSS score and the right next step. Bring any old ultrasound or PSA reports.
Read More
When tablets are enough and when surgery is needed → · Full guide: prostate and urinary symptoms →
