Benign Prostatic Hyperplasia (Enlarged Prostate)

Benign Prostatic Hyperplasia, also referred to as an enlarged prostate, is a common condition suffered by men, commonly after age 50.

ABOUT
Prostate gland enlargement can cause bothersome urinary symptoms. If left untreated, the condition can block the flow of urine out of the bladder and cause permanent bladder or kidney damage.

SYMPTOMS
The severity of prostate enlargement varies in severity among men, but conditions tend to worsen with age. Symptoms of an enlarged prostate include:

  • Weak urine stream
  • Difficulty starting urination
  • Stopping and starting while urinating
  • Dribbling at the end of urination
  • A frequent or urgent need to urinate
  • Increased frequency of urination at night
  • Straining while urinating
  • Not being able to completely empty the bladder
  • Urinary tract infections
  • Formation of stones in the bladder
  • Reduced kidney function

Only about half the men with enlarged prostates experience noticeable symptoms, and symptoms can even stabilize or improve over time. Regardless of the severity or frequency of symptoms, any type of symptoms should be evaluated by a medical professional. If you’re unable to pass urine at all, seek medical attention immediately.

COMMON MISCONCEPTIONS
Contrary to popular belief, the size of your prostate doesn’t necessarily mean your symptoms will be worse. Some with only slightly enlarged prostates experience worse symptoms than those with very enlarged prostates and vice versa.

The key is the degree to which the prostate is symptomatic is the extent to which the prostate gland is growing into the urethral passageway.

CAUSES
At this point in time, it is unknown what causes an enlarged prostate. Although a prostate grows throughout life, an enlarged prostate may be the result of changes in the balance of sex hormones as men grow older.

RISK FACTORS
The main risk factors for BPH are:

  • Age – more common in older men
  •  Family history – more common in families with histories of prostate enlargement
  • Geographic location – more common in American and Australian men

COMPLICATIONS
Prostate gland enlargement becomes a serious problem when it interferes with the ability to empty the bladder. If this occurs, surgery may be the only solution. Complications of an enlarged prostate can include:

  • Acute urinary retention
  • Urinary tract infections
  • Bladder stones & damage
  • Kidney damage

DIAGNOSIS
If you believe you may have an enlarged prostate, an initial evaluation may include:

  • Detailed questions about your symptoms
  • Digital rectal exam
  • Urodynamic exam
  • Urine analysis

Additional tests may include:

  • Prostate-specific antigen
  • Urinary flow test
  • Prostate ultrasound
  • Possible biopsy, cystoscopy, etc

TREATMENT
Those with an enlarged prostate may need to take medications or have surgery. Several types of minimally invasive procedures are also available.

Medications:

  • Alpha blockers
  •  5 alpha reductase inhibitors
  •  A combination drug therapy
  • Tadalafil
  • Nutritional supplements

Surgeries:

  • Transurethral resection of the prostate
  • Transurethral incision of the prostate
  • Open prostatectomy

Minimally invasive procedures:

  • Microwave thermotherapy
  • Radio frequency ablation
  • Freezing the prostate.

LIFESTYLE CHANGES
Regardless of the route of treatment, changes in lifestyle can help control the symptoms. Recommended lifestyle changes include:

  • Limiting beverages in the evening
  • Cutting back on alcohol and caffeine
  • Scheduling bathroom visits
  • Diet, exercise, and weight reduction may also play a role
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