It is located below the bladder (the organ where urine is stored) and surrounds the upper portion of the urethra (the tube that carries urine out of the body).

What are the reasons for this enlargement ?

The reasons are not entirely clear but ageing and hormonal changes appear to play an important role.

What are the complications that can develop if symptoms are ignored ?

	Urine retention.
	Strain on the bladder.
	Bladder stones, Urinary Tract Infections (UTI), Bladder or Kidney damage, Incontinence.

Does the size of the prostate determine severity of symptoms ?

The size of the prostate does not always determine how severe the obstruction or the symptoms will be. Some men with greatly enlarged glands have little obstruction and few symptoms while others whose glands are less enlarged, have more blockage and greater problems. Sometimes a man may not know that he has any obstruction until he suddenly finds that he is unable pass urine at all called, acute urinary retention.

Diagnosis of prostate problems - Medical evaluation will include a 

	History.
	Physical examination.
	Preliminary tests.

The following universal symptoms chart helps you to evaluate your symptoms by yourself and if necessary seek a consultation with a Urologist in your area - 

AUA SYMPTOM SCORE

Physical Examination
A physical examination helps your doctor evaluate your general health. Your doctor will also assess you prostate with a digital rectal examination, performed by inserting a finger into the rectum and feeling the prostate to enable your doctor to detect an enlarged prostate or other abnormalities.

Laboratory Investigations
Urine investigations like urine culture to rule out urinary tract infection. PSA (Prostate specific antigen) blood test is used to detect abnormally high levels of a Protein substance in your blood that may indicate prostate cancer.

Diagnostic tests

These tests serve as baseline tests and over a period of time can be also repeated and a comparison can be done. 

Uroflow :- It measures the velocity of the flow of urine over time. It tells the doctor how slow or fast the urine is flowing and the extent of the blockage due to the prostate enlargement. It is an objective test of your symptoms. You should try and pass urine in the commode provided with the machine, then the urine spills outside the flow test may need to be repeated. 

Ultrasound :- Ultrasound uses sound waves to create a two-dimensional image of your prostate, bladder or kidneys.

Treatment options

If other conditions have been ruled out through tests, your doctor may determine that you have BPH. A Variety of treatment approaches can help solve BPH problems.

Medication

To provide relief for your symptoms, medications may be needed to relax the muscles of your prostate to block hormones that cause prostatic growth, or to relax your bladder and improve continence.

There are two types of surgery to remove excess prostate tissue.

1. Trans-urethral resection of prostate (TURP)

a. This is an endoscopic procedure and usually a spinal or epidural anesthesia may be given for this surgery. 

b. Is the most commonly type of surgery undertaken for an enlarged prostate gland.

c. During this procedure an instrument is inserted through the penis to allow your doctor to see & remove any tissue blocking your urinary passage called the urethra. 

2. Open prostatectomy

a. May be done when a large amount of tissue must be removed or when the size, shape or position of the prostate makes it necessary.

b. An incision is made in the abdomen or the area between the anus and scrotum and the excess tissue is removed.

Frequently asked questions about BPH..

Which specialist should I consult if I have an enlarged Prostate Gland?
You should seek an appointment with a Urologist in your area. If a urologist is not available see a surgeon with an interest in Urology.