The most common symptoms and complications of Benign Prostatic Hyperplasia (BPH)

Benign Prostatic Hyperplasia (BPH) is a common condition that affects many men as they age. It involves the non-cancerous enlargement of the prostate gland, which can significantly impact urinary function and overall bladder health. This article explores the most common BPH symptoms and complications, as well as the importance of appropriate management, and the impact of BPH on sexual function and intimacy. 

Benign Prostatic Hyperplasia (BPH) Symptoms 

BPH symptoms primarily relate to urinary function due to the prostate’s anatomical location around the urethra. The enlargement of the prostate can constrict the urethra, resulting in a variety of urinary symptoms, classified into voiding and storage symptoms.

Voiding BPH Symptoms: 

• Difficulty starting urination: Men with BPH often experience a delay in the initiation of urination, known as hesitancy.
• Weak urine stream: The flow of urine may be weaker than usual.
• Intermittent flow: The urine stream may stop and restart during urination.

Storage BPH Symptoms: 

• Frequency: Increased frequency of urination, especially at night.
• Urgency: A sudden, compelling need to urinate.
• Dysuria: Painful or uncomfortable urination
• Incomplete emptying: There is often a sensation of not fully emptying the bladder.

Complications of Benign Prostatic Hyperplasia (BPH)

If left untreated, BPH can lead to several complications that affect urinary and overall health:

1. Acute Urinary Retention: This is a sudden inability to urinate, causing severe pain and requiring immediate medical attention. It often necessitates catheterization (insertion of a urine tube) to relieve bladder pressure.
2. Chronic Urinary Retention: Incomplete emptying of the bladder over time can lead to bladder damage, infections, and kidney problems.
3. Urinary Tract Infections (UTIs): Stagnation of urine in the bladder can increase the risk of bacterial infections
4. Bladder Stones: These can develop due to concentrated, stagnant urine and can cause irritation, infection, and obstruction.
5. Bladder Damage: Over time, the bladder wall can become thickened and less elastic, reducing its capacity to store urine and leading to more frequent urination.
6. Kidney Damage: Severe bladder damage or high bladder pressure can harm the kidneys, potentially leading to kidney failure.

Importance of Management

Consulting a urologist in Singapore for timely management of benign prostate hyperplasia in Singapore is crucial to mitigating its symptoms and complications. Treatment options vary based on the severity of the condition and may include:

• Lifestyle Modifications: Reducing fluid intake before bedtime, limiting caffeine and alcohol, and practising double voiding (urinating, then waiting a few moments to try again) can help manage mild symptoms.
• Medications: Alpha-blockers (such as tamsulosin or alfuzosin) can relax the muscles of the prostate and bladder neck, making it easier to urinate. 5-alpha-reductase inhibitors (like finasteride or dutasteride) can shrink the prostate over time.
• Minimally Invasive Procedures: Methods such as convective water vapour energy ablation, involve injecting steam into the prostate to shrink it. This quick procedure provides sustained effects and preserves ejaculatory function. Another alternative, the Prostatic Urethral Lift (Urolift), is suitable for some patients and has a lower incidence of sexual side effects.
• Surgery: For larger prostates, surgical options such as transurethral resection of the prostate (TURP) or laser surgery can provide relief by removing or vaporising excess prostate tissue. Alternatively, a robot-assisted simple prostatectomy can be performed, whereby the entire prostate adenoma (benign tumour/BPH) is removed. This is a rarely performed surgery reserved only for very large prostates. 

Impact on Sexual Function and Intimacy 

Erectile Dysfunction (ED): The condition itself or the medications used to treat BPH can contribute to ED.

Reduced Libido: Symptoms and the psychological stress of dealing with BPH can decrease sexual desire.

Ejaculatory Issues: BPH Treatments, especially surgical ones, can lead to retrograde ejaculation, where semen enters the bladder instead of exiting through the urethra.

Visit Assure Urology and Robotic Centre

If you’re experiencing BPH symptoms or have concerns about its impact on your urinary or sexual health, it’s important to seek medical advice. At Assure Urology and Robotic Centre, we specialise in diagnostic and treatment options for BPH to help you identify benign prostatic hyperplasia causes, manage your condition effectively, and maintain your quality of life. Don’t hesitate to contact our urology clinic in Singapore to schedule a consultation and explore an effective BPH treatment plan for you.