What should you know about benign prostatic hyperplasia in older adults?

An enlarged prostate may press on the urine channel beneath the bladder. The result can be hesitancy, a weak stream, dribbling, urgency, frequent urination or waking repeatedly at night. Older adults may also have reduced mobility, memory problems or difficulty reaching the toilet, making a manageable urinary symptom more disruptive. Similar complaints can result from infection, constipation, diabetes, bladder conditions or medicines, so assessment should consider the whole health picture. BPH is non-cancerous, but it is still worth discussing new or changing symptoms with a clinician.

Keep a simple bladder diary showing drinks, toilet visits, urgency and leakage. Reduce caffeine and alcohol if they worsen urgency, avoid heavy fluids shortly before sleep, and keep a clear route to the bathroom. Review every medicine and over-the-counter product with a clinician or pharmacist; some can worsen retention, dizziness or night-time falls. Treatment may be observation, a medicine, or a procedure, chosen according to symptoms, bladder emptying, blood pressure, kidney health, mobility and goals. Do not alter a medicine because of a leaflet or internet advice without checking first.

Book a review if urinary symptoms are affecting sleep, continence, social activities or confidence, or if a stream is gradually becoming weaker. Seek urgent help for inability to pass urine, severe lower-abdominal discomfort, fever or shaking with urinary symptoms, visible blood in urine, or sudden confusion with signs of infection. Prompt review is also sensible after a fall or medication change if dizziness and urgent toileting occur together.

Ask whether symptoms could have more than one cause, which tests check bladder emptying, and how treatment might affect blood pressure, balance or sexual function. Ask who should monitor the plan and what change should trigger an earlier review.