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Benign Prostatic Hyperplasia (Prostate Enlargement)

  • What is Benign Prostatic Hyperplasia or Prostate Enlargement?

    Benign prostatic hyperplasia (BPH) is a non-cancerous swelling of the prostate gland. It is a common urological disorder in men over 50 years old. This swelling of the prostate causes the urethra, the tube that passes the urine out of the penis, to be squeezed and narrowed. This blocks the flow of urine out of the bladder and more pressure is needed to pass urine.

    The bladder starts to contract (tense) even when it is not completely full, and eventually loses its ability to empty itself. The symptoms of BPH are linked with the narrowing of the urethra and the incomplete emptying of the bladder.

  • The cause of BPH is not well known.

    • BHP can occur due to the build-up of the male hormone dihydroxytestosterone (DHT), which is a testosterone involved in the growth of the prostate. The cause of high levels of DHT is not yet understood.
    • It is thought that the hormonal imbalance that occurs with increasing age can be responsible for this condition.
    • Other hormonal changes include low levels of oestrogen (female hormone) and imbalance in other growth factors that control cell division and cell death.
  • Common symptoms of BPH include:

    • Blood in the urine
    • Greater pressure and straining needed to begin urinating
    • Hesitant and interrupted urination
    • Sensation that the bladder is not completely emptied after urination
    • Sudden inability to urinate (acute retention of urine)
    • Sudden urgent need to urinate
    • Urinating more frequently, especially at night
    • Urine leakage
  • Several treatments are available for BPH. A doctor will evaluate the condition and suggest the appropriate treatment, depending on age, the severity of BPH, and the patient's general health. Treatment options include:

    • Drug treatment, which includes 2 broad categories of medication:
      1. Drugs that relax the prostate to reduce the blockage of the bladder opening
      2. Drugs that block the production of the male hormone (DHT) which is involved in prostate enlargement
    • Laser vaporisation for patients with smaller prostate glands, whereby laser energy is delivered, through the urethra, to the prostate gland to destroy enlarged prostate tissues.
  • Surgical treatment to remove the parts of the swollen prostate that are pressing against the urethra. Different surgical methods can be used:
    1. Open surgery is used when the prostate is too large
    2. Transurethral incision of the prostate
    3. Transurethral resection of the prostate
  • Simply wait and observe if symptoms are less severe
    • Bladder and urethra damage
    • Bladder stones
    • Kidney damage
    • Kidney infections
    • Urinary incontinence (loss of control)
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