Enlargement of the prostate, also known as Benign Prostatic Hyperplasia (BPH), is the most common prostate problem among men over 50. About 10 percent of men will likely develop BPH in their thirties, this climbs to 20 percent of men in their forties. Research shows that by age 60, half of all men would have developed BPH, and this increases to 90 percent by age 85. As you advance beyond 20, your prostate starts growing and this could result in urinary symptoms. BPH is different from prostate cancer and does not increase your risk of developing prostate cancer or having sexual problems; it, however, can affect your quality of life by causing urination problems.
What is Enlarged Prostate?
Enlargement of your prostate is referred to as benign prostatic hyperplasia (BPH). This occurs when the cells of your prostate gland start to multiply. This multiplication causes your prostate gland to expand, which compresses your urethra and restricts the flow of urine. The size of your prostate does not determine the severity of BPH symptoms you experience. Some men with moderate prostate enlargement experience severe symptoms, while some with large prostate enlargement do experience minor urinary disorder symptoms.
Symptoms of Enlarged Prostate in Men
The severity of symptoms of BPH in men varies. This, if left untreated could worsen over time. Some common symptoms and signs of an enlarged prostate in men include:
- Urgent or frequent need to urinate.
- Increased rate of urination at night (nocturia).
- Trouble starting urination
- Frail urine stream or an uneven stream
- Slobbering at the end of urination
- Incapability to empty the bladder.
Some rare symptoms and signs of enlarged prostate in men include:
- Blood in the urine
- Urinary tract infection
- Inability to urinate
What Causes Enlarged Prostate in Men?
An enlarged prostate is a common condition, particularly in older men. Most men experience continued growth of their prostate throughout life. In many men, this growth significantly obstructs urine flow. Based on current research, the exact cause of an enlarged prostate remains unknown. That said, changes in the male sex hormones which come with aging are considered a responsible factor.
Other possible causes of urinary symptoms
Conditions that can result in symptoms similar to those incited by BPH include:
- Urinary tract infection
- Swelling of the prostate (prostatitis)
- Contraction of the urethra (urethral stricture)
- Damage to the bladder neck due to previous surgery
- Bladder or kidney stones
- Complications with nerves that regulate the bladder
- Cancer of the bladder or prostate
Factors that Increases your Risk of Developing Enlarged Prostate
Some avoidable and unavoidable factors increase your risk of having BPH as a man.
Unavoidable Risk Factors
Your chances of developing an enlarged prostate increases with age. Men below age 40 rarely have symptoms and signs of prostate gland enlargement. However, by age 60, close to a third of all men experience moderate to severe symptoms of BPH. This increases to half by age 80.
Having a blood relative such as a mother, uncle, and father with a prostate problem increases your risk of developing a prostate problem.
Avoidable Risk Factors
- Lifestyle: Excessive weight (obesity) increases your risk of developing an enlarged prostate, while exercise lowers your risk. Studies show that Obesity results in several mechanisms that include increased intra-abdominal pressure, oxidative stress, altered endocrine status, increased sympathetic nervous activity, and increased inflammation process, all of which are prime factors that increase the risk of developing a BPH.
- Diabetes and heart disease: Studies reveal that diabetes, heart diseases, and the use of beta-blockers might increase your risk of developing BPH. Reports from a study published in the Journal of Urology shows that the symptoms of BPH are worse in men with diabetes compared to those without diabetes. Similarly, age-related impairment of blood supply to your prostate can increase your risk of developing an enlarged prostate.
Diagnosis and Tests
To diagnose an enlarged prostate, your doctor will likely start by asking you some detailed questions about your symptoms, signs, and medical history. This is usually followed by physical check. The physical examinations will likely include the following tests:
- Digital rectal examination: During this test, the doctor places a finger into your rectum to check for prostate enlargement. This test enables the doctor to estimate the shape and size of your prostate.
- Urinalysis: Your doctor will assess a sample of your urine for bacterium infection and blood. This can help rule out the possibility of other conditions with similar symptoms.
- Urodynamic test: This test assesses the pressure of your bladder during urination. This is done by filling your bladder with liquid through a catheter.
- Prostatic biopsy: A small sample of prostate tissue is removed and checked for abnormalities.
- Prostate-specific antigen (PSA) test: This blood test examines the presence of cancer of the prostate.
- Post-void residual: This test measures the quantity of urine left in your bladder after urination.
Your doctor may inquire about medications you’re using that might be upsetting your urinary system, such as:
Treatment for Enlarged Prostate in Men
In determining the best treatment for your BPH, your doctor would consider several factors including your age, overall health, the size of your prostate, and the amount of discomfort you are having into consideration. That said, the treatment options for an enlarged prostate include surgery, medication, and minimally invasive therapies.
Depending on the severity of your symptoms; if it is mild, you might opt to postpone treatment and simply observe your symptoms. For some men, the symptoms ease without any treatment.
Medication remains the most common treatment option for less severe symptoms of an enlarged prostate. Medication options include:
- The use of alpha-blockers: These are medications that relax the bladder neck muscles and the muscle fibers in the prostate, making the process of urination easier. Alpha-blockers include drugs such as alfuzosin (Uroxatral), tamsulosin (Flomax), doxazosin (Cardura), and silodosin (Rapaflo). They are more effective in men with relatively small prostates. Side effects sometimes include dizziness and retrograde ejaculation (a harmless condition which causes the semen to retract back into the bladder instead of gushing out via the tip of the penis.
- The use of 5-alpha reductase inhibitors: These medications contract your prostate by stopping hormonal changes that trigger prostate growth. These medications include dutasteride (Avodart) and finasteride (Proscar). Their usage might take up to six months to be effective. Possible side effects include retrograde ejaculation.
- The use of combination drug therapy: Depending onthe severity of your condition, your doctor might recommend that you use an alpha-blocker together with a 5-alpha reductase inhibitor at the same time.
- Tadalafil (Cialis): Studies show that this medication that is often used in treating erectile dysfunction, can also help with prostate enlargement
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Minimally Invasive or Surgical Therapy
Your doctor might recommend using minimally invasive or surgical therapy if:
- You have moderate to severe symptoms.
- Medication hasn’t eased your symptoms
- You have a urinary tract obstruction, kidney problems, bladder stones, or blood in your urine or kidney problems
- You opt for a definitive treatment
Based on current research there is no way enlarged prostate can be prevented due to some of the unavoidable factors. However, you can be treated and you can minimize your risk by getting more active and staying at the right body weight.