Enlarged Prostate (Benign Prostatic Hyperplasia - BPH)
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The prostate is an organ in the male reproductive system located beneath the bladder and surrounding the upper part of the urethra. Its function is to produce fluid that lubricates and transports sperm during ejaculation.
Causes of Enlarged Prostate
The exact cause is not yet clear. Researchers believe that hormonal changes as men age may lead to prostate enlargement.
Enlarged Prostate in Younger Men
Symptoms of an enlarged prostate are commonly found in men around 50 years old and older. However, younger men can also experience symptoms of an enlarged prostate.
The cause of the condition depends on several factors, such as genetic factors, which play a significant role, and environmental factors, which may be related to diet and could lead to symptoms at a young age. Obesity can also increase the risk. If the symptoms are not severe or bothersome, and no other problems are found (such as urethral stricture, bladder stones, or cancer), treatment can be postponed until the symptoms worsen.
Men aged 30 to 40 years may experience bothersome symptoms of an enlarged prostate, such as needing to wake up to urinate at night, slow urine flow, and sometimes urinary incontinence.
If you are under 45 years old, you should be examined to clearly identify the problem causing urinary tract issues. This could be due to an enlarged prostate or it could be a symptom of problems related to the urethra (such as urethral stricture), or bladder problems (such as bladder cancer or bladder stones), or neurological problems, etc.
Studies show that men may experience symptoms of an enlarged prostate as early as their 20s and 30s. However, it is unusual to start having enlarged prostate symptoms in your 20s. Typically, in men aged 20-30 years, it is often caused by other issues, such as an enlarged prostate due to inflammation from an infection.
What are the Symptoms of an Enlarged Prostate?
Urinary tract symptoms can be caused by various problems, so you should see a doctor for diagnosis.
Other possible causes include:
- Bladder muscle dysfunction
- Nerve damage
- Surgery
- Infection
- Psychological problems
- Certain medications
- Cancerous tumors obstructing the urethra or bladder, etc.
Are burning, difficult, slow, or weak urine flow warning signs of an enlarged prostate?
Urinary tract symptoms can be caused by various problems, so you should see a doctor for diagnosis.
What Happens if an Enlarged Prostate is Left Untreated?
If left untreated, it can cause obstruction in the urethra and symptoms may worsen. It can also lead to:
- Urinary tract infections
- Bladder stones
- Blood in the urine
- Kidney damage from urine flowing back from the bladder to the kidneys. This backflow of urine increases pressure on the kidneys.
Prostate Examination
How Does a Doctor Diagnose an Enlarged Prostate?
- A doctor will take a medical history, including medical conditions, family history, and a history of certain medications that may worsen enlarged prostate symptoms.
- A physical examination will be performed, including a digital rectal exam (DRE) where the doctor inserts a gloved finger into the rectum to check if the prostate is enlarged, soft, or abnormal in other ways.
Other tests include:
- Urinalysis
- Blood test for PSA (Prostate-Specific Antigen)
- Urodynamic testing to see how well you can hold and release urine
- Cystoscopy to view inside the urethra and bladder
- Ultrasound of the prostate and urinary tract
- Prostate biopsy to diagnose or rule out prostate cancer
How to Prevent Enlarged Prostate
There is currently no way to prevent an enlarged prostate, but you can maintain prostate health by:
- Talking to your doctor about your risk of developing an enlarged prostate.
- Getting regular health check-ups.
- Paying attention to the warning signs of an enlarged prostate to receive early treatment.
Can an Enlarged Prostate be Cured?
Not everyone with an enlarged prostate needs treatment. Treatment options depend on symptoms, health, age, and the size of the enlarged prostate:
Certain lifestyle changes can improve symptoms for those with mild conditions, including:
- Drinking less water before bedtime or going out.
- Avoiding or reducing caffeinated and alcoholic beverages.
- Bladder training and exercises for muscles that control urine flow.
- Preventing or treating constipation.
Medications for Enlarged Prostate
Medications can help relieve those with mild to moderate symptoms by:
- Stopping prostate growth.
- Shrinking the prostate.
- Relaxing muscles to increase urine flow.
Sometimes, using two types of medication together may be more effective than using only one.
Other medical procedures can help reduce moderate to severe enlarged prostate symptoms when medications are not sufficiently effective. The doctor may insert instruments into the urethra to:
- Widen the urethra.
- Destroy part of the prostate with heat.
Surgery for Enlarged Prostate
- Removing part or all of the prostate.
- Cutting the prostate to reduce pressure on the urethra.
Who is at Risk of Enlarged Prostate?
- Men aged 40 years or older. The chance of developing an enlarged prostate increases with age.
- Having a family history of enlarged prostate.
- Having certain health conditions such as:
- Obesity
- Heart disease and circulatory problems
- Type 2 diabetes
- Erectile dysfunction
- Lack of sufficient exercise
An enlarged prostate is a benign condition, meaning it is not cancerous and does not lead to cancer. However, an enlarged prostate and cancer can occur at the same time. An enlarged prostate may not require any treatment until symptoms develop.
Approximately half of men aged 51 to 60 have an enlarged prostate, and up to 90% of men over 80 years old experience this condition. However, symptoms of an enlarged prostate can indicate a more serious condition, including prostate cancer.
Research shows that having an enlarged prostate does not increase the risk of developing prostate cancer. However, enlarged prostate and prostate cancer can have similar symptoms.
Each person experiences different symptoms, and some people have no symptoms at all. If you have any of the following symptoms, you should see a doctor immediately:
- Difficulty starting urination
- Weak or interrupted urine flow
- Frequent urination, especially at night
- Problems completely emptying the bladder
- Pain or burning during urination
- Blood in urine or semen
- Chronic back, hip, or pelvic pain
- Pain after ejaculation
However, these symptoms can also be caused by conditions other than prostate cancer.
For early detection of prostate cancer, all men should undergo annual prostate screening after the age of 55, as the risk increases, especially if they are African American or have a family history of prostate cancer. Those at high risk should start prostate screening at age 40.
