Enlarged Prostate (BPH)
BPH is not an uncommon condition, so knowing the signs and treatments help men to determine when it is time to talk to their doctor.
Benign prostatic hyperplasia (BPH) is a condition characterized by the prostate becoming enlarged. It is benign, meaning it is not a cancerous condition.
As men age, the prostate grows in two stages. It doubles in size during early puberty. Around age 25, it starts to grow again and continues to throughout the rest of life. During the second phase is when BPH can occur.
Causes
As the prostate gland starts to enlarge, it may obstruct the flow of urine. The growth is generally associated with aging. By age 60, about one-third of men have this condition. By age 80, one half of men have it. Exactly what causes the enlargement to happen remains unclear. In addition to getting older, other risk factors include:
- Family history
- Being obesity
- Having heart disease
- Having diabetes
Symptoms of Enlarged Prostate
The symptoms and their overall impact varies greatly among men. However, in many cases, they worsen over time. They may include:
- Urgent or frequent feeling to urinate
- Trouble starting urination
- When ending urination, dribbling may occur
- Needing to urinate more frequently at night
- Urine stream stopping and starting
- Weak urine stream
- Not being able to empty the bladder completely
- Not being able to urinate
- Urinary tract infection
- Blood in the urine
Overall, the severity of symptoms is not determined by the size of the prostate. There is the potential for complications in men whose prostate has enlarged. Most men will not experience complications, but it is important to be aware of what these are. They may include urinary retention, bladder stones, kidney damage, urinary tract infections, and bladder damage.
Treatment Options
The first step is getting an accurate diagnosis. Doctors generally perform a physical examination and get detailed information concerning the patient’s medication and medical history. Additional tests may include:
- Digital rectal exam
- Blood testing
- Urine testing
- Checking the blood for PSA levels because they may be increased when the prostate is enlarged
To confirm the diagnosis or to explore BPH that is more complex, additional testing may include:
- Urinary flow test
- 24-hour voiding diary
- Prostate biopsy
- Postvoid residual volume test
- Transrectal ultrasound
- Pressure flow and urodynamic studies
There are also medications that are the most common treatment options. Men may take one or a combination of S-alpha reductase inhibitors to shrink the prostate or alpha blockers to relax the muscles of the prostate and bladder neck. These medications are prescribed to aid in alleviating the symptoms. Doctors might also discuss surgical procedures with their patients, such as:
- Removing all of the prostate, except the outer part
- Destroying the inner area of the prostate using microwave energy
- Allowing for easier urine flow by making specific cuts into the prostate gland
- Destroying excess prostate tissue using radio waves
All of these procedures are considered to be minimally invasive.