If you are a man over 50 who wakes up several times a night to pass urine, or finds the stream weaker than it used to be, an enlarged prostate is the most likely reason. Benign prostatic hyperplasia (BPH) affects about half of men in their 60s and most men by their 80s. The good news is that it is very treatable, and modern laser surgery has made treatment safer and recovery faster.
Common symptoms of an enlarged prostate
- Getting up two or more times at night to urinate
- Weak, slow or stop-start stream
- Waiting for the stream to begin, or straining
- Feeling that the bladder is not fully empty
- Sudden urge to urinate, sometimes with leakage
- Dribbling after finishing
Sudden inability to pass urine, fever, blood in the urine or reduced kidney function are complications that need prompt attention.
Is it BPH or prostate cancer?
BPH is not cancer and does not turn into cancer, but the two can exist together and cause similar symptoms. A PSA blood test and examination are part of every prostate check-up. If PSA is raised, an MRI and targeted biopsy may be advised. See our uro-oncology page for more on prostate cancer.
Tests your urologist will do
- A symptom score questionnaire (IPSS)
- Ultrasound to measure prostate size and urine left in the bladder
- Uroflowmetry to measure how strong your stream is
- PSA, urine and kidney function tests
Treatment step by step
1. Lifestyle changes
Reducing fluids two hours before bed, limiting tea, coffee and alcohol in the evening, and treating constipation can ease mild symptoms.
2. Medicines
Alpha-blockers relax the prostate and improve flow within days. 5-alpha-reductase inhibitors shrink the prostate over months. Many men do well on medicines for years.
3. Surgery
Surgery is advised when medicines stop working, cause side effects, or when there are complications. Options include:
- HoLEP (Holmium Laser Enucleation of the Prostate): removes the entire obstructing tissue with a laser, works for any prostate size, means minimal bleeding and has a very low chance of repeat surgery
- TURP: the traditional standard, suitable for smaller prostates
Read our detailed comparison: HoLEP vs TURP for enlarged prostate.
What recovery from laser prostate surgery looks like
Most men stay in hospital for one to two nights and have the catheter removed within one to two days. Mild burning and urgency improve over a few weeks. Avoid lifting heavy weights and straining for about four weeks. Erections are usually preserved, though many men have dry ejaculation afterwards. This is harmless but worth discussing if you plan to have children.
Prostate specialist in Koramangala
Dr. Bivek Kumar, MCh Urology, is a consultant urologist and andrologist with more than 18 years of experience in laser prostate surgery. He consults at Superhealth Hospital, Salarpuria Tower 1, Marigowda Road, Koramangala (beside Nexus Mall), Monday to Saturday, 9 am to 6 pm. Call +91 90329 59964 to book. Learn more on our prostate laser surgery page.
This article is for general information and does not replace a consultation with your doctor.