Physical examination is performed for diseases other than BPH. An important part of the physical examination for benign prostatic hyperplasia is a digital rectal examination (digital rectal examination). It is entered with the finger in the appropriate position at the breech. The size of the prostate gland is tried to be felt by hand. Examination of the prostate surface may also be important for the diagnosis of prostate cancer.

Diagnosis of benign prostatic hyperplasia: 

It is important to take a good anamnesis from the patient for the diagnosis of benign prostatic hyperplasia. Frequency of urination, daily fluid intake level, urinary incontinence complaints, bleeding etc. are questioned.

Physical examination is performed for diseases other than BPH. An important part of the physical examination for benign prostatic hyperplasia is a digital rectal examination (digital rectal examination). It is entered with the finger in the appropriate position at the breech. The size of the prostate gland is tried to be felt by hand. Examination of the prostate surface may also be important for the diagnosis of prostate cancer.



Some tests may be requested to support the history and examination. Although some of them are for BPH, most of them are important in terms of differentiating other diseases.

  • Urine tests: Urinary tract infections, bleeding due to stone formation can be detected.
  • Blood tests: Kidney function tests, signs of infection are investigated.
  • PSA (Prostate specific antigen) level: It is an important blood test for the differentiation of prostate cancer.
  • Urine flow test: Urine flow rate is examined with uroflowmetry device. Urine flow rate is expected to decrease in BPH.
  • Detection of residual urine in the bladder: Whether the bladder is emptied after urination is determined by ultrasonography. Remaining urine above the normal level suggests BPH.
  • Imaging tests : Rectal ultrasonography is useful for determining prostate size and location. Magnetic resonance imaging may be requested if prostate cancer is suspected.
  • Biopsy: It can be considered in patients with increased PSA level suspected of prostate cancer.
  • Urodynamics : It can be done if a neurological condition is suspected. The contraction level of the bladder muscle is checked.

Treatment of benign prostatic hyperplasia: 

In mild prostate enlargement, if the patient’s complaint is not too much, the best method is to follow up. The patient is checked every six months. Some recommendations are made to the patient.

Recommendations for patients with benign prostatic hyperplasia: 

  • Avoid drinks containing caffeine (increases urine production),
  • Avoid alcohol (increases urine production),
  • Cut down on artificial sweeteners
  • Do not drink after a certain time at night (increases your urination at night),
  • Urinate at certain times (for example, train your bladder by urinating every six hours),
  • Do not hold your urine (it can damage your bladder),
  • Get rid of your excess weight,
  • Exercise regularly, move around,
  • Protect yourself from the cold (increases your urinary frequency),
  • Double urination (urinating again after urinating, thus minimizing urine retention in the bladder),
  • You can use absorbent pads or urine covers against the risk of urinary incontinence,
  • Be careful when using drugs (antihistamines make urination difficult, diuretics urinate frequently).

Drug treatment of benign prostatic hyperplasia:  

It can be preferred especially in mild and moderate benign prostate enlargements. Drug selection is made according to the patient’s age, prostate size, severity of signs and symptoms, and the presence of additional disease. It is necessary to be careful in terms of possible side effects of drugs and to check the prostate at regular intervals.

  • Alpha blockers: They can relax the muscles, making it easier to urinate. In this context, alfuzosin, doxazosin, prazosin, silodosin, tamsulosin, terazosin etc. can be used. It can cause dizziness and sexual problems.
  • 5 alpha reductase inhibitors: Shrink the prostate by increasing testosterone levels. It is preferred in cases where the prostate is 40 grams or more. It can cause sexual problems. In this context, finasteride and dutasteride can be used.
  • Phosphodiesterase type 5 inhibitors: Generally used in male sexual dysfunctions such as erectile dysfunction. It also facilitates urination in BPH patients as it causes relaxation in the muscles.

Surgical treatment of benign prostatic hyperplasia:

Surgery may be preferred in moderate and severe cases that do not respond to drug therapy. There are different surgical treatment options. Depending on the surgical method chosen, complications such as bleeding, difficulty urinating, urinary tract infections, and sexual problems may develop.



The choice of surgical treatment method is made according to the patient’s condition, additional disease, the size of the prostate, the severity of the symptoms or possible complications.

  • TUMP (transurethral microwave thermotherapy): It is entered from the tip of the penis, the excess part of the prostate tissue is burned with the effect of heat and the stenosis in the urinary canal is relieved.
  • TUNA (transurethral needle ablation): It is entered from the tip of the penis, the excess part of the prostate is removed with the needle, the stenosis in the urinary canal is widened.
  • TUIP (transurethral incision of the prostate): It is entered from the tip of the penis, the pressure of the prostate on the bladder is relieved with small incisions, the passage of urine into the urinary canal is relieved.
  • Stend application: A special stent is placed in the prostate, the narrowing of the urinary canal is corrected. It may not be enough on its own, an additional surgical procedure may be required.
  • Open surgery: It is entered through the abdominal skin, the prostate is removed.
  • TUR (transurethral resection): It is entered from the tip of the penis, the prostate tissue is completely removed.
  • Plasmakinetic TUR : It is the washing of the treated area in addition to the TUR procedure. The risk of bleeding is further reduced.
  • Laser surgery: It is the removal of prostate tissue with the help of laser. Different types of laser can be used such as holmium, neodymium, potassium titanyl phosphate, diode. It is one of the most preferred methods today. There are different application methods such as HoLAP, HoLEP, HoLRP. There are publications indicating that it is more tolerable in terms of postoperative complications compared to the TUR method.
  • Robotic surgery: It is the process of entering the prostate tissue with special tools through 5-6 holes opened in the abdomen.

Complementary medicine applications for benign prostatic hyperplasia:

Since it is a common disease and most of the patients are elderly and have additional diseases, some complementary medicine applications have started to take their place in prostate treatment today.

While complementary medicine applications can be applied alone, especially in mild prostate enlargements, it is usually applied in addition to other treatments in moderate and severe prostate enlargements. It is essential that all complementary medicine practices, alone or in addition, are implemented under the supervision of your follow-up doctor and in line with his recommendations.

Herbal products are frequently used among complementary medicine applications. Herbal products often used in BPH are:

  • Pumpkin seeds,
  • Ragweed leaf,
  • South African star plant root,
  • African plum tree bark (used in the form of tea),
  • Rye pollen,
  • American dwarf palm tree fruit,
  • Dead nettle,
  • Tomatoes,
  • Maritime pine resin,
  • Green tea.



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