Benign prostatic hyperplasia (BPH) is a common urologic condition that can significantly reduce quality of life in middle-aged and older men. As the prostate gradually enlarges, it compresses the urethra and causes a range of urinary symptoms. Common signs include frequent urination, urinary urgency, and nighttime urination. These symptoms can lead to poor sleep quality, daily inconvenience, and psychological stress.
Despite these symptoms, many people delay visiting a hospital if the discomfort seems mild or manageable. Some patients assume the symptoms are simply part of normal aging. Others may hesitate because of concerns about treatment costs and instead rely on unproven home remedies. However, leaving BPH untreated can eventually lead to more serious complications.
The exact cause of BPH has not been fully identified. However, because most patients are middle-aged or older men, aging is considered a major contributing factor. Changes in male hormone levels are also believed to play a role.
One of the challenges is that early symptoms of BPH may not seem severe and often occur without noticeable pain, making them easy to ignore. However, prolonged obstruction caused by an enlarged prostate can lead to significant damage to the bladder and kidneys. Continuous pressure on the bladder can weaken its ability to contract properly, resulting in incomplete bladder emptying and persistent residual urine.
If this condition continues, the bladder wall may thicken and bladder function may decline further. In some cases, even if surgery later removes the enlarged prostate tissue, bladder function may not fully recover.
Severe prostate enlargement can also increase the risk of urine flowing backward toward the kidneys. This may lead to conditions such as pyelonephritis or reduced kidney function. Once kidney function is damaged, recovery may be difficult and the condition can progress to chronic kidney failure. In addition, persistent residual urine creates an environment where bacteria can grow easily, increasing the risk of recurrent urinary tract infections and cystitis. In advanced cases, BPH may even lead to acute urinary retention.
For these reasons, proactive treatment of BPH is recommended. When symptoms are mild, medication can help relieve urinary problems. However, if symptoms worsen or do not respond to medication, surgical treatment may become necessary.
Today, several surgical options are available, allowing treatment to be tailored to each patient’s condition. These include holmium laser enucleation of the prostate (HoLEP), which removes enlarged prostate tissue using a holmium laser; Rezūm therapy, which reduces prostate tissue using heated water vapor; prostatic urethral lift procedures such as UroLift; and waterjet robotic surgery known as aquablation.
Because treatment options vary depending on factors such as the patient’s health condition, prostate size and location, and the presence of complications, the choice of surgery should be individualized. Costs can also vary between different procedures, making informed decision-making important. Rather than choosing a treatment method based solely on general information, it is recommended to consult with a urology clinic that offers multiple treatment options and receive a personalized treatment plan.
Dr. Kim Tae-heon of Goldman Urology Clinic’s Seoul Station branch explained that BPH does not improve naturally over time. He emphasized that middle-aged and older men should take prostate health seriously and undergo regular checkups for early diagnosis and treatment. He added that starting treatment while symptoms are still mild can help protect bladder and kidney function while maintaining quality of life.