Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a very common condition in middle-aged and older men. It is a benign condition.
What is BPH?

The prostate is a male organ located below the bladder and around the urethra, that carries urine out of the body. Its function is to produce fluid that helps protect sperm.

As men get older, the prostate may gradually enlarge. This enlargement can press on the urethra and make urination more difficult. Aging, obesity, and Western-style dietary patterns are described as contributing factors.

How common is it?
The article states that about half of men older than 50 have this condition, and the rate rises to around 70% by age 70.

Common symptoms

BPH symptoms are often divided into two groups.

1. Obstructive symptoms
These symptoms happen when urine has trouble passing through the urethra:
· Hesitancy.
· Intermittency.
· Weak stream.
· Incomplete emptying.
· Dribbling after urination.

2. Irritative symptoms
These symptoms are related to bladder irritation or poor bladder control:
· Frequent urination, more than 8 times a day.
· Sudden desire to urinate.
· Waking up 2 or more times at night to urinate.
Doctors often use the International Prostate Symptom Score (IPSS) to assess severity: 0–7 is mild, 8–19 is moderate, and 20–35 is severe.

How is BPH evaluated?
A urologist may use several methods to assess BPH:
· Medical history and symptom review.
· Digital rectal examination to check the size and firmness of the prostate.
· Urinalysis to rule out infection.
· Ultrasound and urine flow testing to measure prostate size and evaluate urination.

Does everyone need surgery?
No. Not all patients need surgery, and about half of patients can improve with medication alone.

Mild symptoms
Patients with mild symptoms may only need observation, lifestyle adjustment, and regular follow-up.

Moderate symptoms
Medication may be used, including drugs that relax the bladder outlet and drugs that reduce prostate size.
Severe symptoms or complications

Surgery or minimally invasive treatment may be needed if BPH causes complications such as:
· Acute urinary retention.
· Overflow incontinence.
· Bladder degenerative change.
· Recurrent bleeding or infection.
· Bladder stones.
· Kidney function deterioration.

Treatment options
Standard endoscopic surgery
· TURP (transurethral resection of the prostate): a standard surgical treatment covered by Taiwan’s National Health Insurance.
· Laser prostate surgery: Reduce bleeding risk and may be useful for older patients, patients with chronic illness, or those taking blood thinners.

Minimally invasive options
· Urolift: uses implants to pull prostate tissue away from the urethra and can help preserve ejaculation function.
· Rezum: uses hot water vapor to destroy enlarged prostate tissue to induce necrosis, which is later absorbed by the body.

Prostatic artery embolization (TAE)
TAE uses catheter-based techniques to reduce blood supply to the prostate. Current guidance generally considers its long-term results and urine flow improvement somewhat less favorable than resection or laser surgery, so it is not usually a first-line treatment.

Daily self-care tips
The article recommends the following daily habits to support prostate health:
· More vegetables and fruits.

· Reduce animal fat and red meat.

· Drink enough water during the day, but drink less after dinner, including soup.

· Avoid alcohol and spicy foods.

· Bladder training.

· Cooked tomatoes may help increase lycopene intake.

Important medication warning
Some cold or allergy medicines, such as antihistamines, may make urination worse and can even trigger sudden urinary retention. Patients should tell their doctor that they have BPH before taking new medications.

When to see a doctor
See a urologist if urination problems affect daily life, sleep, or quality of life. Prompt evaluation is also important if there is inability to urinate, blood in the urine, repeated urinary tract infections, or worsening bladder symptoms.

Frequently asked questions

Is BPH the same as prostate cancer?
No. BPH is a benign enlargement and is not the same as prostate cancer.

Can BPH improve without surgery?
Yes. Many patients improve with lifestyle changes or medication, and only some need surgical treatment.

How can prostate health be maintained?
The article recommends healthy weight control, more fruits and vegetables, less alcohol and high-fat food, enough daytime water intake, less drinking at night, and regular follow-up.