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King Charles is getting treatment for an enlarged prostate. What is benign prostatic hyperplasia?

It's a condition common amongst thousands of men each year, but is an enlarged prostate something to be concerned about?

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

King Charles attends the Royal Family's Christmas Day service at St. Mary Magdalene's church, as the Royals take residence at the Sandringham estate in eastern England, Britain on Dec. 25, 2023. (REUTERS/Chris Radburn/File Photo)
King Charles is set to get treatment for an enlarged prostate, according to Buckingham Palace. (REUTERS/Chris Radburn/File Photo)

King Charles is heading to the hospital next week for a condition affecting his prostate, according to Buckingham Palace.

"In common with thousands of men each year, the King has sought treatment for an enlarged prostate," the palace shared in a statement on Wednesday. "His Majesty's condition is benign and he will attend hospital next week for a corrective procedure."

The 75-year-old British monarch was set to attend a series of meetings and events in Scotland on Friday, but the palace added his "public engagements will be postponed for a short period of recuperation."

Following the announcement, NBC News reported that a source from the palace noted the King "was keen to share the details of his diagnosis to encourage other men who may be experiencing symptoms to get checked, in line with public health advice."

The news came less than two hours after Kensington Palace shared Kate Middleton, 42, will be spending the next 10 to 14 days in the hospital following a successful "planned abdominal surgery."

An enlarged prostate, also known as benign prostatic hyperplasia, is a very common condition amongst men, particularly those who are older. But is this condition dangerous or something to worry about? Read on to learn more.

News of King Charles and Kate Middleton's health conditions were announced less than two hours apart on Jan. 17. (Photo by Chris Jackson/Getty Images For Buckingham Palace)
News of King Charles and Kate Middleton's health conditions were announced less than two hours apart on Jan. 17. (Photo by Chris Jackson/Getty Images For Buckingham Palace)

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia (BPH) is an enlarged prostate, where the cells of the gland get bigger, Dr. Kirk Lo, a urologist at Toronto's Mount Sinai Hospital, told Yahoo Canada.

The prostate is a gland that's part of the male reproductive and urinary systems that produces some of the fluid in semen. Usually around the size of a walnut in younger men, it sits deep in the pelvis, below the bladder and in front of the rectum, according to the Canadian Cancer Society.

The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. But if the prostate grows, it may squeeze or partially block the urethra, potentially causing issues with urination.

What causes benign prostatic hyperplasia?

Experts are unsure why the prostate will grow in size, but factors related to aging and hormones are thought to play a role. Additionally, BPH tends to be more common in western countries as opposed to eastern countries, according to Johns Hopkins Medicine.

An enlarged prostate can press or partially block the urethra, causing issues with urination for some men. (Photo via Getty Images)
An enlarged prostate can press or partially block the urethra, causing issues with urination for some men. (Photo via Getty Images)

Who's at risk of benign prostatic hyperplasia?

Age is the biggest factor when it comes to BPH. While the prostate usually continues to grow throughout a perosn's life after around the age of 25, men who are older have a greater chance of developing BPH.

"By the time we're 40 or 50, [men] have mild to moderate prostate enlargement, or BPH, and it will continue to get bigger as long as we have our testosterone," Lo explained.

Other risk factors include having extra fat on your abdomen and not getting enough exercise.

By age 70, almost all men will have some prostate enlargement. Around 50 per cent of men between the ages of 51 and 60 have BPH. That number rises to 70 per cent among men aged 60 to 69, and jumps to 80 per cent in men over 70 years old, according to Yale Medicine.

What are the signs and symptoms of benign prostatic hyperplasia?

Sometimes, people with BPH will not have any symptoms. Lo, who's also an associate professor at the University of Toronto, shared some people's prostates will remain moderate or large.

"But the majority of men eventually, in our late 50s, 60s and 70s, will start having urinary symptoms," he shared. "There's a term for this: Lower urinary tract symptoms, LUTS.

"Most men just live with it until they get into trouble."

BPH can cause some of the following symptoms:

  • Difficulty urinating

  • More frequent urination, especially at night

  • Strong or sudden urges to urinate

  • Weak or slow urine stream

  • Inability to completely empty the bladder, which can lead to urinary tract infections or bladder stones

  • Difficulty starting to urinate

  • Difficulty controlling the bladder

  • Blood in the urine

Signs and symptoms of BPH will arise when the enlarged prostate puts pressure on the urethra and bladder. (Photo via Getty Images)
Signs and symptoms of BPH will arise when the enlarged prostate puts pressure on the urethra and bladder. (Photo via Getty Images)

Can benign prostatic hyperplasia lead to prostate cancer?

Since it's benign, BPH is a non-cancerous condition, meaning it won't spread to other parts of the body and usually isn't life-threatening. It also does not increase the risk of prostate cancer, according to the Canadian Cancer Society.

However, if a patient comes in with BPH-like symptoms, Lo said health-care providers have to "entertain that they could have prostate cancer."

"Prostate cancer doesn't usually, but could have similar symptoms," he shared. "For our patients, we have to rule out prostate cancer. However, BPH does not cause [and is] not related to prostate cancer."

What should I do if I have benign prostatic hyperplasia?

If your health-care practitioner believes you might have BPH, they'll send you for tests to diagnose the condition, or rule out other problems like a urinary tract infection or prostate cancer. If you are diagnosed with BPH, you and your health-care practitioner will discuss possible treatments, if required.

Lo explained treatment typically only occurs when a patient can no longer tolerate their symptoms, or if their BPH is causing problems in other parts of the body like the kidneys.

How is benign prostatic hyperplasia treated?

While many men can tolerate their symptoms until treatment is required, Lo noted most health-care practitioners will start treating patients with medical therapy. That could include medications that help relax the muscles near the prostate to help relieve pressure on the urethra, or other medications to reduce the size of the prostate. "If that doesn't help, they'll go on to surgical options," he added.

Surgery is used to treat BPH when medications stop working or if someone has severe symptoms, such as kidney failure due to an inability to urinate. The most common surgical procedure is transurethral resection of the prostate, or TURP, which removes prostate tissue from the urethra. Other procedures include laser prostatectomy to destroy prostate tissue, full surgery to remove the prostate as well as a non-surgical option called Rezūm, which uses water vapour therapy to help shrink the prostate.

Which treatment for benign prostatic hyperplasia is better?

Lo noted there are pros and cons to both medical therapy and surgery when treating BPH — and it mostly comes down to personal preference.

"Some people, for example myself, I'd probably go for surgery earlier rather than later," he added. "I don't want to be on medication indefinitely. Again, personal preference."

While some medications may cause ejaculatory dysfunction, Lo explained that most people who choose the surgical route will see those issues afterwards, as well as erectile dysfunction . However, he said many of his patients who chose the latter don't have regrets.

"I have so many patients who, after the surgery, they ask themselves, 'Why didn't I do that earlier? I'm peeing like I'm 20 years old,'" he noted.

Still, Lo urged people to visit their health-care practitioner if they have concerns.

"Men should see their doctors as they get older and they have urinary symptoms," he said. "Just go because we do have treatment — they don't have to suffer."

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