Enlarged Prostate (BPH): Why It Happens and What Can Be Done

Ultimo aggiornamento: Agosto 15, 2026

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Benign prostatic hyperplasia — BPH, or simply an enlarged prostate — is one of the commonest things men come to see me about. It rarely arrives suddenly. The symptoms build so gradually that most men adjust around them for years before mentioning it to anyone, which is a shame, because it is very treatable.

Symptoms that suggest BPH

• A weak stream, and having to strain to get going
• The sense that the bladder never quite empties
• Getting up at night to pass urine, and waking tired because of it
• Passing urine more often through the day
• A sudden, hard-to-defer urge to go
• Dribbling at the end, or a stream that splits

None of these is dangerous in itself. What they cost is sleep, confidence and the freedom to be far from a toilet — and that is reason enough to have them assessed rather than tolerated.

• Centro di urologia Ospedale di Bangkok Thailandia Prenotazione online 02-310-3009 bhquro@bdms.co.th
• Ospedale Samitivej Sriracha Chonburi 088-022-1445

Why the prostate enlarges

BPH is suspected mainly in men aged 50 and over, and three conditions have to be met for it to develop at all:

1. A prostate gland. Obvious, but it makes the point — BPH does not occur without prostatic tissue.
2. Androgen. The male hormone drives prostatic growth. Men with androgen insufficiency from birth do not develop BPH, which is what established the hormone’s role.
3. Age. The consistent finding across the literature is that ageing is the fundamental trigger. The gland gains both more cells and larger ones over time, which is why measuring prostate size is part of the assessment.

Read those three together and the conclusion follows: an ageing man with normal hormones will develop some degree of BPH. US data bear that out — it affects 50% of men aged 50 and over, 70% of those aged 60–69, and more than 80% of men aged 70 and above. This is not a disease you catch or bring on yourself; it is closer to a feature of male ageing.

What you can actually influence

BPH cannot be prevented outright, since neither ageing nor androgen is optional. Its pace is another matter, and two risk factors are within your control:

1. Sindrome metabolica — there is strong evidence that hypertension, diabetes and dyslipidaemia increase prostate size.
2. Obesità — which appears to raise oxidative stress within prostatic tissue and contribute to enlargement.

Controlling blood pressure and blood sugar, losing excess weight and staying active will not shrink the prostate, but they slow the trajectory — and they happen to be the same measures that protect the heart and the erections, which makes them an easy recommendation.

Why it is worth treating rather than tolerating

Left long enough, obstruction has consequences beyond inconvenience: infezione della vescica from urine that never fully clears, bladder stones, a bladder muscle that thickens and eventually works poorly, and — in severe, long-standing cases — damage to the kidneys.

The one that brings men to the emergency department is acute urinary retention — suddenly being unable to pass urine at all, with a painfully full bladder. BPH is its commonest cause, and treating the prostate properly reduces the risk of ending up there.

One thing to be clear about

BPH is not prostate cancer, and it does not turn into prostate cancer. It is not a pre-cancerous condition. The two can coexist, and they cause overlapping symptoms, which is exactly why the assessment includes examination and a PSA discussion rather than assuming one or the other.

Opzioni di trattamento

Mild symptoms that do not bother you may need nothing more than monitoring. Where they do bother you, medication is the usual first step and works well for most men. For those who want to come off long-term tablets or who have not responded to them, water vapour therapy (Rezum) is a minimally invasive day-care procedure available at Bangkok Hospital Headquarters — there are also patient instructions for what the procedure involves.

Se hai riscontrato sintomi urinari correlati all'IPB o desideri esplorare opzioni di trattamento, inclusa la terapia con vapore acqueo, la Dottoressa Soarawee Weerasopone offre consultazioni specialistiche presso Bangkok Hospital Headquarters. Prenota una consulenza. È possibile fissare un appuntamento presso l'Ospedale Samitivej Sriracha chiamando il reparto di urologia al numero 088-022-1445.

Domande Frequenti sull'Iperplasia Prostatica Benigna (IPB)

Disclaimer: Questo contenuto è stato scritto e revisionato dal Dr. Soarawee Weerasopone, urologo certificato presso la sede centrale del Bangkok Hospital. È destinato unicamente a scopi educativi e non costituisce un parere medico. Nessun parere medico, diagnosi o prescrizione viene fornito tramite canali di messaggistica personale. Consultare sempre un professionista sanitario qualificato prima di iniziare qualsiasi trattamento medico.