Benign prostatic hyperplasia (BPH) is one of the common health conditions many middle-aged men eventually face. BPH occurs when the prostate gland enlarges and compresses the urethra, leading to urinary symptoms such as weak urine stream, frequent urination, or difficulty emptying the bladder. Although it is a common age-related condition, the discomfort it causes for patients can be significant.
In many cases, symptoms can be managed with medication. However, if symptoms do not improve despite medical treatment, or if complications such as severe urinary obstruction, kidney function impairment, recurrent urinary tract infections, or bladder stones develop, surgical treatment may need to be considered. When BPH is left untreated for a long period, urine can flow backward toward the kidneys, potentially causing kidney damage. For this reason, regular monitoring is essential after a diagnosis of BPH.
One case involved a 52-year-old male patient whose prostate had enlarged to the point that urine began refluxing toward the kidneys. As a result, his kidney function deteriorated and his creatinine level—an important marker used to assess kidney function—rose to 2.9 mg/dL. Considering that the normal creatinine level is generally below 1.2 mg/dL, this indicated a potentially serious condition that could progress to kidney failure.
Several years earlier, the patient had been told that his prostate measured approximately 50–60 cc. However, he did not undergo regular follow-up examinations, so the progression of the enlargement went unnoticed. About one month before visiting the clinic, he began experiencing significant difficulty urinating and sought care at a urology clinic. Examination revealed that his prostate had enlarged to 115 cc.
Further evaluation using cystoscopy showed that both lateral lobes of the prostate were almost completely touching each other, while the median lobe had also enlarged significantly and was blocking the urinary passage.
Because holmium laser enucleation of the prostate (HoLEP) can effectively treat large prostates—including those larger than 100 cc—HoLEP surgery was performed. After the procedure, the patient’s prostate size decreased from 115 cc to 28.9 cc. As a result, the bladder outlet reopened, allowing urine to pass normally again. His kidney function also recovered, and his creatinine level returned to the normal range. The patient reported high satisfaction with the surgical outcome and was able to urinate normally once again.
This case highlights the importance of regular monitoring in patients with prostate enlargement. Regular checkups help track the progression of benign prostatic hyperplasia and allow early detection of potential complications. Important evaluations include prostate-specific antigen (PSA) testing, prostate ultrasound, and uroflowmetry with post-void residual urine measurement. Through routine examinations, physicians can assess disease progression and determine the most appropriate treatment strategy at an early stage.
According to data from the Health Insurance Review and Assessment Service (HIRA) in Korea, the number of patients diagnosed with benign prostatic hyperplasia has increased by approximately 19.7% over the past five years. The total number of patients is now approaching 1.5 million. As society continues to age, the prevalence of BPH is expected to increase further.
Although BPH is a common condition, appropriate management and timely treatment can significantly relieve symptoms and prevent complications. For patients diagnosed with BPH, regular follow-up with a urology specialist is essential to maintain urinary health and overall quality of life.
As men age, various urologic conditions may begin to interfere with daily life. By providing objective and practical information about urologic health, the goal is to help individuals maintain a healthier and more comfortable life during middle age and beyond.