Enlarged Prostate (BPH)

The walnut-sized prostate gland naturally increases in size with age, usually when men are in their forties.

An enlarged prostate, also referred to as benign prostatic hyperplasia (BPH), becomes a problem if the nearby bladder and urethra are affected. An enlarged prostate may also cause problems with urination and nearby organs like the kidneys.

• From medication to minimally invasive surgery, there are many treatment possibilities.
• If it's suspected that you have an enlarged prostate, you may be referred to a urologist for further evaluation.

Who Has an Enlarged Prostate?

It's estimated that approximately half of all men in their fifties have an enlarged prostate. This number is even higher for men beyond this age range. Some men dismiss changed in urination habits as an inevitable part of the aging process. However, ignoring the problem can lead to other serious problems with the urinary system and its various structures.

Signs of a Prostate That's Enlarged

A larger than normal prostate often results in frequent urination, especially at night. The size of the prostate doesn't always suggest what symptoms may be experienced. It's possible for a man with a prostate that's only slightly enlarged to have more severe symptoms than one with a significantly enlarged gland. Signs and symptoms suggesting prostate enlargement include:

• Frequent urges to urinate
• Not feeling like urination is complete
• Disruptions in urine flow or weak urine streams
• Visible blood in urine
• An inability to urinate

How Is Prostate Enlargement Diagnosed?

It's usually problems with urination that bring patients to a urologist. Diagnosis typically involves a digital rectal examination (DRE) and lab work that includes urine and blood tests. A prostate-specific antigen (PSA) blood test checks for elevated levels of an enzyme released by the prostate. Higher levels generally suggest some type of problem with the prostate, although levels can also be high due to recent surgery or an infection. Additional assessment can involve image tests, a urine flow study, and a special procedure done with a lighted scope that provides a better view of the prostate (cystoscopy). In some cases, a prostate biopsy is done to rule out cancer.

Treatment

Medication is the most common treatment for a prostate that's enlarged and causing problematic symptoms. Alpha-blockers work by relaxing prostate and bladder muscles and tissues. 5-alpha reductase inhibitors minimize hormone changes related to prostate growth. Some men benefit from a combination of medications. If symptoms aren't able to be sufficiently controlled by medication, minimally invasive surgery may be recommended. Depending on the specific procedure performed, the prostate may surgically cut to relieve pressure on the urethra or reduced in size with microwaves or radio waves. An enlarged prostate can also result in a urinary tract infection or kidney or bladder stones that will also need to be treated.

Having a family history of prostate problems and being overweight are some of the risk factors that can increase your odds of experiencing problems with an enlarged prostate. There's also research suggesting that being diabetic, using beta-blockers, and having heart disease may increase the risk of BPH. Some patients with minor symptoms see improvements when they make certain lifestyle changes, such as opting for foods that may boost prostate health, getting more exercise, and losing weight.