Benign prostatic hyperplasia, commonly known as BPH, is a non-cancerous enlargement of the prostate gland that affects many men as they age. The condition can lead to troublesome urinary symptoms that range from mild inconvenience to significant disruption of daily activities, sleep, and overall quality of life. While BPH is common, it is not an inevitable part of ageing, and a wide range of effective treatments are available.
What Is Benign Prostatic Hyperplasia?
Benign prostatic hyperplasia occurs when the prostate gland gradually increases in size and begins to press on the urethra, the tube that carries urine from the bladder out of the body. This can interfere with the normal flow of urine and affect bladder function.
The rate of prostate growth and severity of symptoms vary widely between individuals. Some men may have a significantly enlarged prostate with minimal symptoms, while others experience bothersome symptoms even with modest enlargement.
What Is Benign Prostatic Hyperplasia?
Common Symptoms
Symptoms of benign prostatic hyperplasia are a common cause of lower urinary tract symptoms in men. These may include:
● Increased frequency of urination
● A sudden or urgent need to pass urine
● Waking at night to urinate (nocturia)
● Difficulty starting urination
● A weak or slow urine stream
● Stopping and starting during urination
● A feeling that the bladder has not emptied completely
● Dribbling of urine after finishing
Symptoms may develop slowly over time and often worsen if left untreated.
Assessment and Investigation
A careful and structured assessment is essential to confirm the diagnosis of benign prostatic hyperplasia and to exclude other possible causes of urinary symptoms.
Mr Jeremy Nettleton provides comprehensive assessment for men with suspected BPH. This begins with a detailed consultation to understand symptom severity, progression, and the impact on daily life.
Investigations may include:
● Symptom scoring questionnaires
● A bladder diary
● Blood tests, including PSA where appropriate
● Urinary flow rate testing
● Bladder scanning to assess residual urine
● Ultrasound imaging of the prostate and urinary tract
● CT or MRI scans when clinically indicated
These investigations allow treatment to be tailored precisely to the individual.
Management and Treatment Options
Many men with benign prostatic hyperplasia can be managed successfully without surgery. Initial treatment often includes lifestyle advice and medication designed to relax the prostate or reduce its size, improving urinary flow and bladder emptying.
When symptoms are moderate to severe, or when complications such as urinary retention develop, surgical treatment may be recommended. The choice of treatment is based on prostate size, symptom severity, overall health, and personal preference.
Aquablation for Benign Prostatic Hyperplasia
Aquablation is an advanced, minimally invasive treatment for benign prostatic hyperplasia.
Mr Nettleton is an internationally recognised expert in Aquablation and was the first surgeon to perform this procedure in the South West of England. He runs one of the UK’s reference centres for Aquablation and regularly hosts visiting consultant surgeons.
Aquablation uses a high-pressure water jet guided by real-time imaging to precisely remove prostate tissue while preserving surrounding structures. It has a strong and growing randomised evidence base and offers excellent symptom relief while maintaining continence, erectile function, and ejaculatory function. Reported complication rates compare favourably with other surgical options.
Transurethral Resection of the Prostate (TURP)
Transurethral resection of the prostate (TURP) remains the most established surgical treatment for benign prostatic hyperplasia and has a long history of reliable symptom improvement.
Mr Nettleton leads nationally recognised day-case TURP outcomes and runs a teaching programme for visiting consultant surgeons. He offers TURP in both NHS and private practice, using modern techniques and careful patient selection to optimise results.
Possible Complications of Untreated BPH
If left untreated, benign prostatic hyperplasia may lead to complications such as:
● Acute urinary retention
● Recurrent urinary tract infections
● Bladder stones
● Bladder damage
● Kidney impairment
Early assessment helps reduce the risk of these complications.
When to See a Urologist
You should seek specialist advice if urinary symptoms:
● Persist or gradually worsen
● Interfere with sleep or daily activities
● Are associated with pain, infection, or blood in the urine
● Do not improve with medication or lifestyle changes
Timely evaluation allows access to the full range of effective treatment options.
Book a Consultation
If you are experiencing symptoms of benign prostatic hyperplasia and would like a clear diagnosis and personalised treatment plan, you are welcome to book a consultation with Mr Jeremy Nettleton, Consultant Urologist. A thorough assessment will ensure your symptoms are fully understood and the most appropriate management options discussed.