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Benign prostatic hyperplasia

Hyperplasia prostatae benigna · Nezhoubné zvětšení prostaty (BHP)

male only

What it is

The prostate grows through midlife and squeezes the urethra.

Symptoms & signs

  • Weak stream
  • hesitancy
  • dribbling
  • nocturia
  • incomplete emptying
  • urgency
  • retention

🚩 Get help if…

  • call 112 / 911 now Unable to pass urine with a painful swollen lower belly
  • see a doctor soon Blood in the urine
  • see a doctor soon Fever or burning with urinary symptoms
  • see a doctor soon Wetting the bed or passing much less urine than usual

Where it strikes

Medical treatment

  • Tamsulosin
  • finasteride or dutasteride
  • tadalafil
  • TURP
  • water-vapour therapy (Rezum)
  • prostatic urethral lift (UroLift)
  • aquablation
  • temporary implantable nitinol device (iTIND) — FDA-authorised 2020

Natural & lifestyle

  • Reduce evening fluids, caffeine and alcohol
  • double voiding
  • saw palmetto — no better than placebo in large trials not confirmed in trials
  • beta-sitosterol
  • pelvic floor training
  • weight loss

Emerging & experimental

  • Prostatic artery embolisation
  • water-vapour refinements

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Saw palmetto — large trials (STEP, CAMUS) found no benefit over placebo not confirmed in trials
  • Pygeum africanum — small trials, modest benefit mixed evidence
  • Pumpkin-seed extract — small trials early / small studies
  • Stinging-nettle root — small trials early / small studies

ICD codes