Prostate health covers a range of common conditions from benign enlargement (BPH) that causes urinary symptoms to prostate cancer – all are are assessed and managed with clear, risk‑stratified pathways so men can make informed choices about investigation and treatment.
The prostate is a small gland beneath the bladder that contributes to semen and surrounds the urethra; as men age the gland commonly enlarges and can cause urinary symptoms. Benign prostatic hyperplasia (BPH) is very common and becomes more likely with increasing age; many men over 50 experience some degree of lower urinary tract symptoms (LUTS). These symptoms typically include storage symptoms such as frequency, urgency and nocturia (waking at night to pass urine), and urinating symptoms such as a weak stream, hesitancy, intermittency, straining and a sensation of incomplete emptying. BPH is not cancer, but when symptoms are moderate or severe it can affect quality of life and sometimes lead to complications such as acute urinary retention or recurrent infections.
Assessment begins with a focused history and symptom score, physical examination including a digital rectal examination (DRE), urine testing and blood tests such as prostate‑specific antigen (PSA) when appropriate. Where indicated, targeted imaging, ultra sound scan and/or multiparametric MRI of the prostate are used to clarify diagnosis and guide management. These steps help distinguish benign causes of LUTS from conditions that require further oncological assessment.
Management of BPH is tailored to symptom severity, prostate size and patient preference. Treatment options range from lifestyle measures and oral medications to minimally invasive and day‑case surgical procedures designed to relieve obstruction and improve urinary flow. Shared decision‑making is essential so men understand the expected benefits, risks and recovery associated with each approach. When symptoms are mild, lifestyle adjustments and medications such as alpha‑blockers or 5‑alpha‑reductase inhibitors are often effective. For men with more significant obstruction or lowered response to medication, surgical options are considered. Common procedures include TURP (transurethral resection of the prostate), GreenLight laser vaporisation, and the UroLift implant system, each offering different advantages depending on prostate anatomy, symptom profile and patient priorities.
Prostate cancer is one of the most common cancers in men and becomes increasingly frequent with age; while many prostate cancers are slow‑growing and suitable for active surveillance, higher‑risk disease requires more definitive treatment such as focal therapy, radical prostatectomy, radiotherapy or systemic therapies for advanced stages. Management is always risk‑stratified and guided by a multidisciplinary team to ensure that treatment aligns with the cancer’s behaviour as well as the patient’s overall health, life expectancy and personal preferences.
Prostate cancer diagnosis usually begins with a digital rectal examination (DRE) and a PSA blood test. If results raise concern, a multiparametric MRI (mpMRI) is arranged, which provides a detailed view of the prostate and helps determine whether a biopsy is necessary.
When there is clinical suspicion or imaging suggests clinically significant cancer, a prostate biopsy is taken from multiple parts of the gland for histological analysis.
