Prostate enlargement (BPH)
Medical therapy through to laser enucleation and TURP, chosen against your symptom burden rather than prostate size alone.
What it is
The prostate enlarges in almost every man with age. Enlargement on its own is not a disease — what matters is whether it is obstructing the flow of urine and how much that is affecting your life.
Many men do well for years on medication and monitoring. Surgery becomes the right answer when symptoms stop responding, or when obstruction starts to threaten the bladder or the kidneys.
Symptoms you may notice
- A weak or interrupted stream
- Hesitancy — waiting for the flow to start
- Straining to pass urine
- A feeling of incomplete emptying
- Getting up two or more times a night
- Urgency, or leaking before reaching the toilet
- Dribbling at the end of passing urine
Get seen promptly if
- Complete inability to pass urine — needs immediate catheterisation
- Recurrent urinary infections or bladder stones
- Blood in the urine
- A rising creatinine with a full bladder on scan
How it is assessed
- Symptom scoring (IPSS) and a bladder diary
- Uroflowmetry and post-void residual measurement
- PSA, to exclude cancer as a cause
- Ultrasound of the kidneys, bladder and prostate
- Urodynamics in selected or previously failed cases
- Flexible cystoscopy where indicated
What the options actually involve
Other conditions
Urinary incontinence & overactive bladder
Stress incontinence, urge urinary incontinence, overactive bladder, prolapse and pelvic floor assessment for women of every age.
Symptoms and treatmentUrethral stricture & genitourinary fistula
Urethroplasty and fistula repair, including redo cases referred after a previous repair has failed.
Symptoms and treatmentUrinary infection & recurrent UTI
A single infection is usually simple. Infections that keep coming back are a different question, and the answer is rarely another course of antibiotics.
Symptoms and treatmentHave a scan or report about this already?
Send it before your appointment. The consultation then starts from your findings rather than from scratch.