Benign prostatic hyperplasia (BPH) is a common condition amongst older men and is

associated with lower urinary tract symptoms and erectile dysfunction; these symptoms can

be burdensome and negatively affect quality of life. Various surgical and pharmaceutical

treatment options exist but there is a paucity of qualitative research exploring men’s decision-

making when seeking BPH treatment. This study qualitatively explored men’s experience of

living with BPH and seeking treatment for BPH. Twenty men (aged 52-75) were recruited

from outpatient urology clinics at a hospital trust in Southern England. Data were collected

using semi-structured interviews (via video or telephone call) and were audio-recorded;

transcripts were analysed using thematic analysis. Four themes were generated: “Impacts are

about more than just physical symptoms”, “The path towards treatment”, “The process of

information gathering’, and “Navigating hopes, fears and uncertainty”. Results indicate most

men appear to seek treatment for BPH following a gradual, and sometimes lengthy, period of

deterioration in symptoms; for some men, however, treatment seeking follows an acute

episode of sudden or severe symptoms. The decision to proceed with surgical or minimally

invasive treatment options appears to be dependent on men reaching a tipping point; they no

longer perceive their symptoms as tolerable and feel their ability to cope with symptoms is

reduced. Men each bring their own set of concerns and preferences about side effects and

risk-benefit profiles of different treatments. Clinicians need to be sensitive to these individual

differences and incorporate them into shared decision-making for choosing between

treatment options for BPH.