What is an enlarged prostate (BPH) and who does it affect?
Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland that can obstruct urine flow. It is one of the most common urological conditions in men, becoming increasingly prevalent with age. Deccan Hardikar Hospital in Pune offers comprehensive urology services for the diagnosis and management of BPH, including non-surgical treatment pathways.
BPH is not prostate cancer and does not increase the risk of developing it. However, left unmanaged, it can significantly affect quality of life and, in some cases, lead to complications such as urinary tract infections or kidney stress.
Key fact: BPH affects the prostate gland, which surrounds the urethra. As the gland enlarges, it can squeeze the urethra and make urination difficult.
What are the 5 warning signs of an enlarged prostate?
BPH symptoms arise from the prostate pressing on the urethra or bladder. They range from mild inconvenience to significant disruption of daily life. The five most recognised warning signs are:
- Frequent urination — needing to urinate more often than usual, especially at night (nocturia)
- Weak or interrupted urine stream — reduced force or a stream that starts and stops
- Difficulty starting urination — hesitancy or straining before urine begins to flow
- Incomplete bladder emptying — a persistent feeling that the bladder has not fully emptied
- Urgency and leakage — a sudden, strong urge to urinate that is difficult to defer
Additional symptoms may include dribbling at the end of urination or pain during urination. Symptoms do not always correlate with prostate size — some men with mildly enlarged prostates have severe symptoms, and vice versa.
Warning: If you are unable to urinate at all, experience blood in the urine, or have severe lower abdominal pain, seek emergency medical attention immediately.
How is BPH diagnosed, and what is the PSA test?
Diagnosis of BPH involves a combination of symptom assessment, physical examination, and targeted investigations. A urologist at Deccan Hardikar Hospital in Pune will typically follow a structured diagnostic pathway:
| Test / Assessment | Purpose |
|---|---|
| IPSS Questionnaire | International Prostate Symptom Score — grades symptom severity |
| Digital Rectal Exam (DRE) | Allows the doctor to feel the size and texture of the prostate |
| PSA Blood Test | Measures Prostate-Specific Antigen to help rule out prostate cancer |
| Urinalysis | Checks for infection or blood in the urine |
| Uroflowmetry | Measures urine flow rate and volume |
| Ultrasound (TRUS or abdominal) | Estimates prostate volume and checks for residual urine |
The PSA test is recommended when symptoms suggest BPH, particularly in men over 50, or when the doctor needs to distinguish BPH from prostate cancer. An elevated PSA does not confirm cancer — it is one data point among several. Your urologist will interpret results in clinical context. Accurate diagnostic testing is available through Deccan Hardikar Hospital's diagnostics services.
What is the best treatment for an enlarged prostate without surgery?
Many men with BPH can be managed effectively without surgery. Treatment choice depends on symptom severity, prostate size, and the patient's overall health. The main non-surgical options are:
- Watchful waiting (active surveillance) — Suitable for mild symptoms (IPSS score ≤7). Involves lifestyle adjustments and regular monitoring. No medication is required at this stage.
- Lifestyle modifications
- Reducing fluid intake in the evening
- Limiting caffeine and alcohol
- Practising bladder training and double voiding
- Maintaining a healthy body weight
- Alpha-blockers — Relax the muscles of the prostate and bladder neck to improve urine flow. Effects are typically noticed within days to weeks.
- 5-alpha reductase inhibitors (5-ARIs) — Reduce prostate size over several months by blocking the hormone that drives prostate growth. Often combined with alpha-blockers for moderate-to-severe symptoms.
- Combination therapy — Using an alpha-blocker and a 5-ARI together is recommended in men with larger prostates and moderate-to-severe symptoms.
- Minimally invasive procedures — When medication is insufficient but surgery is not preferred, options such as UroLift or steam therapy (Rezum) may be considered. Your urologist will advise on availability and suitability.
Note: Natural remedies such as saw palmetto are sometimes discussed online, but clinical evidence for their effectiveness in BPH is inconsistent. Always discuss any supplement with your urologist before use.
For men whose symptoms do not respond to non-surgical management, surgical options such as TURP (Transurethral Resection of the Prostate) remain available. The urology team at Deccan Hardikar Hospital will guide you through the most appropriate pathway for your individual case.
What is the difference between BPH and prostate cancer?
BPH and prostate cancer are distinct conditions that can share some urinary symptoms, which is why clinical evaluation is important. Understanding the key differences helps men make informed decisions about seeking care.
| Feature | BPH | Prostate Cancer |
|---|---|---|
| Nature | Non-cancerous (benign) | Malignant |
| Spreads to other organs? | No | Can spread if untreated |
| PSA levels | May be mildly elevated | Often significantly elevated |
| Urinary symptoms | Common and prominent | May be absent in early stages |
| Confirmed by | Clinical assessment, ultrasound | Biopsy |
BPH does not cause prostate cancer and does not increase the risk of developing it. However, because symptoms can overlap, a urologist will use PSA testing and, where indicated, imaging or biopsy to rule out malignancy.
When should you see a urologist for urinary problems?
Many men delay seeking help for urinary symptoms, attributing them to normal ageing. However, early assessment leads to better outcomes and more treatment options. Consult a urologist if:
- Urinary symptoms have persisted for more than 4 weeks and are affecting sleep or daily activities
- You are waking more than twice per night to urinate
- You notice blood in the urine at any point
- You experience pain or burning during urination
- You have a complete inability to urinate — this is a medical emergency
- Symptoms have worsened despite lifestyle changes
- You are over 50 and have not had a prostate health assessment
Men with a family history of prostate conditions are advised to discuss screening with a urologist from the age of 45.
Book a urology consultation at Deccan Hardikar Hospital
Located at 1160/61, University Rd, Shivajinagar, Pune 411005. Use the booking form on this page to schedule your appointment.
How does Deccan Hardikar Hospital in Pune approach BPH care?
Deccan Hardikar Hospital in Shivajinagar, Pune is a NABH Pre-Accredited superspeciality hospital with five decades of surgical and clinical experience across Western Maharashtra. The hospital's urology department provides structured, evidence-based care for BPH — from initial symptom assessment and diagnostic workup through to medical management and, where required, surgical intervention.
The hospital's approach is built around three principles:
- Patient-centric care — treatment plans are tailored to each patient's symptom profile, age, and preferences, with non-surgical options explored first wherever clinically appropriate
- Transparent cost advantage — patients are informed of costs at each stage, with no hidden charges
- Comprehensive in-house diagnostics — PSA testing, uroflowmetry, and ultrasound are available within the hospital, reducing the need for external referrals
Deccan Hardikar Hospital also offers laparoscopic and minimally invasive surgical services for cases requiring procedural intervention, ensuring continuity of care within a single facility. For patients requiring joint or musculoskeletal care alongside their urology needs, the hospital's multidisciplinary structure — including joint replacement surgery — means coordinated management under one roof.