What is enlarged prostate?
An enlarged prostate is the slow growth of the prostate gland, which is involved in the production of seminal fluid and reproductive function in men. The prostate wraps around the tube that transports urine out of the bladder. It is very common for the prostate gland to become enlarged as a man ages. An enlarged prostate is also known as benign prostatic hyperplasia (BPH). BPH is generally not caused by infection or cancer.
As a man matures, the prostate grows. At puberty, the prostate doubles in size. At about age 25, the prostate gland grows again, and this can lead to an enlarged prostate as a man enters his 40s (Source: NIDDK).
An enlarged prostate many not cause any symptoms or noticeable problems in some men. However, as men age, an enlarged prostate may grow to the point where it presses on the bladder and urethra, causing urine flow to be slower and less forceful. Symptoms of enlarged prostate are very common in men in the 60s and extremely common in men in their 70s and 80s.
If an enlarged prostate prevents complete emptying of your bladder, it may lead to a urinary tract infection or permanent damage to your bladder, including the inability to control urination (incontinence). The earlier the enlarged prostate is found, the more effective treatment will be, lowering the risk for complications.
Your health care provider must determine whether your symptoms are a result of enlarged prostate or are the result of other prostate diseases and disorders, such as an infection or cancer. Seek immediate medical care (call 911) if you have high fever (higher than 101 degrees Fahrenheit), severe rectal pain, or the inability to urinate . Seek prompt medical care if you experience other symptoms along with enlarged prostate, including burning or pain during urination, cloudy urine, or lower back pain, or if you are being treated for an infection or prostate cancer but mild symptoms recur or are persistent.
What are the symptoms of enlarged prostate?
Symptoms of enlarged prostate generally include the blockage of the urethra, a gradual loss of bladder function, and incomplete emptying of the bladder. The severity of the symptoms will vary from person to person and the symptoms may not be dependent on the size of the prostate. Some men with very enlarged prostates have few or no symptoms, while those with a lesser degree of prostate enlargement may experience more severe symptoms.
Common symptoms of enlarged prostate
You may experience enlarged prostate symptoms daily or just once in a while. At times any of these symptoms can be severe:
- Frequent urination at night
- Frequent urination that often produces only a small amount of urine
- Hesitant or interrupted urine stream
- Leaking or dribbling urine
- Sudden and urgent need to urinate
- Weak urine stream
In some cases, enlarged prostate can be related to a serious condition that should be immediately evaluated promptly. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:
- Abdominal or rectal pain that can be severe
- High fever (higher than 101 degrees Fahrenheit)
- Inability to urinate
What causes enlarged prostate?
As a man matures, the prostate grows. At puberty, the prostate doubles in size and at about age 25, the prostate gland grows again. This continued growth can lead to an enlarged prostate as a man enters his 40s.
What causes the prostate to grow throughout a man’s lifetime is not known. Scientific research has focused on several theories for enlarged prostate, including changes in a man’s hormone levels. These theories on hormonal changes that may cause enlarged prostate include:
- A drop in male hormones (testosterone) and an excess of female hormones (estrogen)
- Continuing accumulation of a growth hormone (dihydrotestosterone, or DHT)
- Inactive growth hormones that are “reawakened” as a man ages
Your health care provider must determine whether the enlarged prostate may be a symptom of a more serious prostate disease or disorder, including prostate cancer.
The risk factors for enlarged prostate are not known. Not all people with risk factors will get enlarged prostate. Risk factors for enlarged prostate include:
- Aging process
- Changes in hormonal levels
How is enlarged prostate treated?
Treatment for enlarged prostate will vary depending on the severity of the symptoms. Your health care provider may start with drug treatment before considering more invasive options, such as surgery.
Medications for enlarged prostate inhibit hormone production, and this can cause the prostate to stop growing. These medications include:
- Dutasteride (Avodart)
- Finasteride (Proscar)
Other medications for enlarged prostate work by relaxing the prostate muscle and bladder neck to improve urine flow. These drugs are called alpha blockers and include:
- Alfuzosin (Uroxatral)
- Doxazosin (Cardura)
- Tamsulosin (Flomax)
- Terazosin (Hytrin)
Minimally invasive therapy
Minimally invasive therapy may be recommended if medications do not work. These treatment options, such as transurethral microwave procedures, transurethral needle ablation, and water-induced thermotherapy, use heat, light or water to destroy excess prostate tissue.
Surgical removal of the enlarged portion of the prostate is considered the best long-term option for treatment of enlarged prostate. Some forms of surgical treatment for enlarged prostate are associated with post-treatment complications, such as incontinence, bleeding, and changes in sexual function.
What you can do to improve your enlarged prostate
You can maintain good prostate health by having your prostate examined annually by your health care provider. Tell your health care provider about any changes in your urinary flow or any difficulties that you are having with urination. You can improve your symptoms by:
- Avoiding alcohol and caffeine
- Avoiding over-the-counter decongestant or antihistamine medications, as these can worsen symptoms
- Exercising regularly
- Managing stress and eating a healthy diet
- Performing pelvic strengthening exercises
- Urinating when you first feel the need
If an enlarged prostate goes unchecked and prevents complete emptying of the bladder, it may lead to permanent damage to the urinary system. The earlier the enlarged prostate is found, the more effective treatment will be, lowering the risk for complications.
You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of enlarged prostate include:
- Kidney or bladder damage
- Kidney or urinary tract stones
- Urinary retention
- Urinary tract infections