Enlarged Prostate (Benign Prostatic Hyperplasia): Symptoms, Causes and Treatments

An enlarged prostate — known medically as benign prostatic hyperplasia (BPH) — is a non-cancerous growth of the prostate that affects most men as they age. It is not cancer and does not turn into cancer, but the urinary symptoms it causes can take a real toll on sleep and quality of life. The good news is that highly effective treatments exist today, from medication to HoLEP laser surgery, that resolve the problem for good.

This guide explains what BPH is, why it happens, how to recognize the symptoms, how it is diagnosed, and the treatment options available in Puebla.

The prostate is a walnut-sized gland that is part of the male reproductive system and surrounds the urethra, the tube through which urine leaves the body. After a certain age, this gland tends to grow. When that growth squeezes the urethra, it makes urinating harder and symptoms appear. The word “benign” is key: it means this growth is not a malignant tumor and is not directly related to prostate cancer.

Symptoms come on gradually and are often mistaken for a “normal part of aging.” The most common are a weak or interrupted urine stream, difficulty or delay starting to urinate, a feeling of not fully emptying the bladder, needing to urinate often (especially at night), sudden urgency and dribbling at the end.

As symptoms progress, repeated urinary infections, blood in the urine, or — in severe cases — the inability to urinate (urinary retention) can appear. Retention is a medical emergency.

The main cause is aging, together with the natural hormonal changes in men, particularly the effect of dihydrotestosterone (DHT) on the prostate. A family history of prostate problems, as well as metabolic factors such as obesity or diabetes, can increase the likelihood or intensity of symptoms.

Benign hyperplasia and prostate cancer are different diseases: one does not cause the other, and having an enlarged prostate does not raise your cancer risk. The challenge is that their early symptoms can look alike, and both become more common with age. A urology evaluation confirms that BPH is the cause and rules out other conditions.

Diagnosis combines your history and symptom assessment with simple tests: a digital rectal exam to assess the size and consistency of the prostate, a prostate-specific antigen (PSA) blood test, and in some cases a uroflowmetry or ultrasound to see how the bladder empties. With this information, the urologist chooses the best treatment for each patient.

Not every case needs surgery. Watchful waiting with simple habit changes may be enough when symptoms are mild. Medication helps relax the prostate or shrink it and improves urine flow. HoLEP laser surgery — Holmium laser enucleation of the prostate — is the state-of-the-art technique for an enlarged prostate, especially for large glands: no external incisions, minimal bleeding, fast recovery and durable results.

Dr. Bruno Rubí López is an international expert and PROCTOR in HoLEP surgery, which means he not only performs the procedure but also trains other urologists in the technique.

If you get up several times a night to urinate, feel you don’t empty your bladder, or your stream has weakened, an evaluation is worthwhile. Treating BPH early prevents complications and noticeably improves quality of life. There is no need to wait until symptoms become severe.