What is an Enlarged Prostate?
Enlarged prostate is a noncancerous condition whereby the prostate gland grows and puts pressure on the bladder and urethra. This can impede the flow of urine and cause frequent urination.
Also called benign prostatic hyperplasia (BPH), this condition affects one in five men aged between 50 and 60. The numbers increase even more as you get older. (1)
The prostate is a gland that forms part of the reproductive system in men. It produces seminal fluid during ejaculation and is situated below the bladder in front of the rectum. This is also in very close proximity to the urethra which carries urine from the bladder to the penis. (2)
The causes of enlarged prostate are not fully known but there are some predisposing factors. These are:
Risk of enlarged prostate generally starts after the age of 40 years and increases the older you get. By the time you get to 60 years old there is a fifty fifty chance of having this condition.
The prostate is about the size of a walnut but after age 40 can grow to the size of a large plum. The reason for this growth after this age is not known. (3)
The male hormone, or androgen, testosterone is produced by men, along with a small amount of the female hormone estrogen. With age the levels of testosterone found in the blood decrease leaving the proportion of estrogen higher. It is thought that these decreasing levels of testosterone can induce growth of the prostate. (4)
There is also another male hormone, dihydrotesterone (DHT), which encourages prostate development and growth. Even though testosterone levels drop, DHT is still produced and high levels can build in the prostate encouraging growth. (5)
Men who are overweight or do little exercise are at higher risk of this condition. Regular exercise at a moderate to high level can reduce the risk by as much as 25 percent. (6)
The location of the prostate gland has a lot to do with the symptoms when it becomes enlarged. It’s located close to the bladder and the urinary tract therefore most of the symptoms relate to the function of both.
The need to urinate becomes more frequent, it could be eight times or more every day. There will also be a need to urinate more at night, disturbing your sleep and leaving you tired.
Your need to use the bathroom can become more urgent and you may even suffer from incontinence. It is also common to find that urine will dribble after you have used the bathroom.
On the other hand you could find that you have trouble starting to urinate or the stream is interrupted and weak. Your urine could also have an unusual smell or color.
It is possible that even after using the bathroom you might not have not emptied your bladder completely. This contributes to urinary tract infections as well as urinary incontinence.
Pain can be felt during urination or after ejaculation when having sex. (7,8)
The symptoms are most likely the result of a blocked urethra or a bladder that is overworked.
However, the symptoms don’t present in all men, they can vary greatly. A larger prostate doesn’t always mean the symptoms will be worse either. Some men may have a small enlargement but experience more signs than their counterparts with larger prostates.
There are factors other than enlarged prostate which can produce these symptoms like allergy medications and antihistamines.
Some decongestants can prevent the neck of the bladder relaxing and stop the release of urine. Certain antihistamines also have side effects which include difficulty or pain when urinating and urinary retention.
Drinking alcohol, long periods of inactivity and very cold temperatures can cause urinary retention.
It is worth bearing all of this in mind should you start experiencing any of these symptoms. (9)
The diagnosis of this condition will be based on medical history, both personal and family. There will also be a physical examination and possible medical tests.
You should tell your doctor about the symptoms you are experiencing, how long you have had them and how often they happen. They will want to know if you are taking any medication, both prescribed or over the counter.
They will be interested in how much fluid intake you have and whether you drink caffeinated drinks or alcohol.
During this examination you will be checked for urethral discharge and tender or enlarged testicles. The doctor will also feel the lymph nodes situated in the groin to see if there are any changes in size or if they are tender to the touch.
The prostate will also be examined via a digital rectal examination. This involves the doctor placing a lubricated, gloved finger into the rectum to feel the prostate. Whilst this may be uncomfortable you will not need any anesthesia. (10)
A rectal examination may be done as part of a routine physical if you are over 40 years old.
Dependant on the doctors findings there are more tests that may be required. These include:
A urine sample can be taken and tested at the doctors or sent off to a laboratory. It can detect any infections that may be present. (11)
PSA Blood Tests
PSA is a type of protein made in the prostate gland and can be detected via a blood test. While it is used to test for prostate cancer, high levels can also be an indication of: enlarged prostate, inflammation, prostate infections and aging. (12)
Urodynamic tests examine how well your bladder and urethra work in relation to urination.
They focus mainly on how well the bladder retains urine and how efficiently it empties the urine.
Some of these tests need a local anesthesia and others don’t. Your doctor will advise you accordingly. (13)
This procedure uses a cystoscope, a thin tube with a light and camera one the end and an eyepiece on the other. It is inserted through the penis to examine the inside of the urethra and bladder.
It can detect any blockage which may be present as a result of an enlarged prostate.
Local or general anesthesia can be administered to carry out this test. (14)
This rectal ultrasound uses a transducer, a device slightly larger than a pen, inserted into the anus. It uses sound waves to create an image of the nearby internal organs. It can detect the size and any abnormalities in the prostate. (15)
During this procedure a sample of the prostate is taken so that it can be examined in a laboratory. An imaging scan is generally used to guide a needle into the correct location for the sample to be obtained.
A local or general anesthetic will be administered for this test which aims to detect or negate prostate cancer. (16)
What is an enlarged prostate? Enlarged prostate is a noncancerous condition whereby the prostate gland grows and puts pressure on the bladder and urethra. This can impede the flow of urine and cause frequent urination.
What causes an enlarged prostate? The exact cause of this condition is not known but there are predisposing factors. These include age, hormones and obesity.
How do doctors test for an enlarged prostate? Following an initial examination the doctor can perform a rectal examination. Further imaging tests, urine tests, blood tests or a biopsy may be required.
When should you go to the doctors with an enlarged prostate? If you experience any urinary problems as you get older you should see your doctor. There are times when these can cause infection and be a medical emergency. These include an inability to urinate, abdominal pain which is severe or a swollen bladder that you are able to feel. (17)
Can you prevent an enlarged prostate? There are no known measures that can prevent enlarged prostate but early diagnosis minimizes the effects. It’s important to recognize the warning signs and see your doctor if you are concerned. (18)
What can relieve an enlarged prostate? Following a healthy diet, avoiding alcohol and exercising regularly can help manage the symptoms of enlarged prostate.
How is an enlarged prostate treated? Treatment options for this condition include lifestyle changes, medication and surgery. Dependent on your symptoms your doctor will advise what is best for you.
Can herbal supplements help an enlarged prostate? There are many herbal supplements marketed as helpful for issues with the lower urinary tract. However their efficacy has not been scientifically proven.(19)
Enlarged prostate is considered a noncancerous condition causing the prostate gland to grow and put pressure on the bladder and urethra. This medical issue can be both uncomfortable and embarrassing, meaning men can’t move too far away from a bathroom.
It affects men generally over the age of 40 years and the older a man gets the more likely he is to suffer from enlarged prostate.
Not all men will experience symptoms of this condition but if they do it can interfere with their everyday life. Fortunately there are treatments available that help manage the symptoms.