An enlarged prostate, also called benign prostatic hyperplasia (BPH), is one of the top health concerns among men over the age of 60.
The prostate gland is located between the penis and bladder, and produces the seminal fluid that travels through the urethra. It’s typically the size and shape of a walnut, but may grow unusually large when men reach their early forties. Growth is an irreversible process that occurs naturally with age.
Though men with an enlarged prostate may not experience any symptoms, the growth can narrow the urethra or press on the bladder muscle, increasing sensitivity. In these cases, men will need to see a urologist for diagnosis and treatment.
Signs of an Enlarged Prostate
The bladder will often try to compensate for an enlarged prostate. But if the urethra becomes severely compressed, the bladder will be unable to function properly. As a result, men may experience recurring urinary tract infections, kidney problems, and urine blockages.
It’s important to note that the size of the prostate doesn’t influence symptom severity. Men with a slightly enlarged prostate may suffer from more related issues than patients with a severely enlarged gland. Noticeable signs and symptoms associated with BPH include:
- Urine leakages
- Blood in the urine
- Frequent urination, oftentimes at night
- Weak urine stream
- Difficulty starting to urinate
Potential Causes and Contributing Factors of BPH
Aging is a leading factor associated with an enlarged prostate. Men with a family history of prostate enlargement are also at increased risk of developing BPH.
Over time, an increase in the production rate of cells (hyperplasia) causes the prostate to grow larger. It’s unclear why this happens, but hormonal changes may be a factor. Other conditions that may contribute to BPH include scarring in part of the bladder after surgery, kidney stones, and prostate inflammation (prostatitis).
Diagnosing BPH
To accurately diagnose BPH, the urologist will need to evaluate the results of blood and urine tests, a urinary flow test, and a digital rectal exam to feel if the prostate is enlarged. Some patients may also need to undergo a prostate-specific antigen (PSA) blood test since PSA levels increase when a prostate is enlarged.
Patients may need to keep a diary for 24 hours to track how often they urinate and how much urine they produce. A prostate biopsy may also be necessary to rule out prostate cancer.
Enlarged Prostate Gland Treatment
The treatment plan will be personalized according to the size of the enlargement, the patient’s overall health, and symptom severity.
The first step in a treatment plan for BPH typically involves medication, such as alpha blockers, 5-alpha reductase inhibitors, or a combination of these two medications (combination drug therapy). If symptoms worsen and disrupt daily life, or if urine flow becomes blocked and medication isn’t effective, patients may need to undergo surgery.
Surgery may include laser therapy, open or robot-assisted surgery, prostate lift, minimally invasive procedures, and Rezūm. Patients should speak to their physician to find out which surgery is recommended for their situation.