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Enlarged Prostate Symptoms, Causes, and Treatment

Enlarged Prostate Symptoms, Causes, and Treatments

Man speaking with doctor about enlarged prostate symptoms and treatments.

Introduction

As men age, benign prostatic hyperplasia (BPH), also known as prostate gland enlargement, is common. A enlarged prostate gland can lead to uncomfortable symptoms such as a blocked urine flow and other urinary problems. It can also lead to problems involving the bladder, urinary tract, or kidneys.

There are many effective options for treating prostate gland enlargement. These include prescription drugs, minimally invasive treatments, and surgery. You should talk with your doctor about your symptoms, prostate size, and other concerns that might affect your decision.

Signs Of An Enlarged Prostate

People with prostate gland enlargement may experience symptoms of varying degrees of severity. However, symptoms tend to get worse over time.

Typical BPH symptoms and signs include:

  • Urinary urgency or frequency.
  • Nocturia (increased nighttime urination).
  • Having difficulty starting urination.
  • A urine stream that is weak or stops and then starts.
  • Urination finishes with dribbling.
  • Unable to empty the bladder completely.

The following are some less common symptoms and signs:

  • Infection of the urinary tract (UTI).
  • Blood in the urine.
  • Being unable to urinate.

The severity of your symptoms may or may not be affected by the size of your prostate. Some men with very enlarged prostates may only have minor symptoms. and some men with a prostate that’s only slightly enlarged can experience significant symptoms. 

Additionally, some men may experience symptoms that sooner or later stabilize, and may even improve gradually.

Other Factors Causing Urinary Symptoms 

The following conditions can cause symptoms similar to those associated with an enlarged prostate:

  • Prostatitis (inflammation of the prostate).
  • Infections of the urinary tract.
  • Bladder and/or kidney stones.
  • Problems with involving nerves of the bladder.
  • Prostate or bladder cancer.
  • Urethral stricture (narrowing of the bladder).
  • Scarring of the bladder neck due to past surgery.

When Should You See A Doctor?

Talk to your doctor if you’re experiencing any issues with your urinary function. Even if your symptoms aren’t that severe, it’s important to pinpoint or eliminate any underlying causes.

If left untreated, obstructions of the urinary tract could occur. You should seek immediate medical attention if you are unable to pass urine.

Causes of Prostate Enlargement

Chart depicting a normal prostate and an enlarged prostate.

Your prostate gland rests underneath the bladder. The prostate’s center is where the urethra passes, which is the tube that transports urine from the bladder to the penis.

When the prostate becomes enlarged, it inhibits the flow of urine.

Most men experience steady prostate growth throughout their lives. This continued growth can cause symptoms in the urinary tract or a blockage of urine flow.

The exact cause of prostate enlargement is not known. It is believed that it could be related to changes in sex hormone balance as men age.

Factors That Could Pose Risk

Some of the risk factors for prostate gland enlargement are:

  • Aging – Men younger than 40 are very unlikely to experience symptoms of prostate gland enlargement. By the age of sixty, around 1 out of 3 men will have moderate to severe symptoms, and around half of all men will by the age of eighty.
  • Certain Medical Conditions- Research shows that there is an increased risk for BPH in those who have diabetes, heart disease, or use beta blockers.
  • Family History – Prostate problems are more common in those who have a close relative with prostate issues, such a father or brother.
  • Lifestyle Factors – BPH risk is increased by obesity, but exercise can reduce your risk.

Conditions Caused By BPH

An enlarged prostate may cause complications such as:

  • UTIs (urinary tract infections). Your risk of developing a urinary tract infection can increase if you are unable to empty your bladder fully. UTIs that occur often may require surgery to remove a portion of your prostate.
  • Bladder stones. Typically caused by an inability to empty the bladder fully. Bladder stones can lead to infection and irritation of the bladder, blood in the urine, and urinary obstruction.
  • Urinary retention (Sudden inability to urinate). catheter (or tube) may be necessary to drain the urine from your bladder. A few men suffering from an overactive prostate might need surgery to alleviate the urinary retention.
  • Bladder damage. If your bladder isn’t empty completely, it can gradually become stretched and weakened. This causes an inability of the bladder’s muscular wall to contract properly, making it more difficult for you to empty your bladder fully.
  • Kidney damage. Bladder pressure caused by urinary retention can damage the kidneys, or even lead to kidney infections.

These complications are unlikely in men with an enlarged prostate. Nevertheless, sudden and severe urinary retention or kidney damage can pose serious health risks.

Additionally, having an enlarged prostate is not thought to increase your chances of getting prostate cancer.

Diagnosing BPH

To gather the information necessary to make a diagnosis, your doctor will ask detailed questions about your symptoms, and perform a physical exam. The initial exam will likely include:

  • Digital Rectal Examination – To check for prostate enlargement, the doctor inserts a finger in your rectum.
  • PSA Test – PSA (prostate-specific antigen) is a substance that your prostate produces. An enlarged prostate can increase your PSA levels. High PSA levels may also occur as a result of infection, surgery, or prostate cancer.
  • Urine Analysis – Testing a urine sample can be used to rule out infection or other conditions that could cause symptoms similar to an enlarged prostate.
  • Blood Analysis – To determine the possibility for kidney problems.

Your doctor may recommend further tests to confirm an enlarged prostate or to rule out the possibility of other conditions. These tests include:

  • Urinary flow testing: To measure the strength and volume of your urine, you need to urinate into a receptacle that is attached to a machine. The results of your tests will help you determine if your condition has improved or worsened over time.
  • Test for post-void residual volume: This test determines if you can fully empty your bladder. This test is done by an ultrasound, or a by using a catheter that’s inserted into the bladder in order to see how much urine is left.
  • 24-hour urination log. Keeping a record of how often and the amount you urinate may prove especially useful if you have frequent nighttime visits to the bathroom.

Your doctor might recommend these tests if your condition is more complicated:

  • Ultrasound – To evaluate and measure your prostate, an ultrasound probe is inserted into the rectum.
  • Biopsy – A transrectal ultrasound guides the needles that are used to perform the biopsy (taking a tissue sample) on the prostate. Your doctor can examine the tissue to either diagnose or rule out cancer of the prostate.
  • Urodynamic Testing – Used for men who are suspected of having neurological problems, or men who have had a previous prostate procedure but are still having symptoms. A catheter is inserted into the bladder through your urethra and  is slowly filled with water (or air in some cases). Your doctor will then measure bladder pressure to determine the strength and condition of your bladder muscles.
  • Cystoscopy – Your doctor will insert a flexible, lighted instrument, called a cystoscope, into your urethra to allow them to view inside of your bladder and urethra. Before the test, you will be administered a local anesthetic.

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