Overview
Prostate enlargement is a condition that occurs in men, primarily men over 40 years old. Benign prostatic hyperplasia is the term for the enlargement of the prostate gland. This condition can cause various urinary symptoms, including bladder, kidney, and urinary tract issues. In some cases, an enlarged prostate can block the flow of urine from the bladder.
As the prostate gland is underneath the bladder, the urethra passes through the prostate. When the prostate becomes enlarged, pressure can close the urethra, blocking the flow of urine. Prostate growth throughout a man’s life is normal. It is only where the prostate enlarges to the point of causing symptoms that there is a concern.
The primary factor that causes prostate enlargement is believed to be the gradual change in sex hormone balance as men age. In general, prostate enlargement symptoms are rare in men under 40 years old. By age 80, roughly half of men are affected.
Symptoms
The severity of symptoms varies widely, and they generally become worse over time after first appearing. Typical symptoms include:
- A frequent need to urinate
- Frequent urination at night
- Difficulty beginning urination
- A urine stream that stops and starts
- Inability to empty the bladder
- Weak Urinary Stream
- Urgency of Urination
Prostate enlargement can also lead to urinary tract infections in some cases.
Diagnosis
A physician will ask the patient questions about the extent and severity of their symptoms, their medical history, and their urination habits. They will also likely order a urine test to check for urinary tract infections that can cause many of the same symptoms as prostate enlargement.
A digital rectal exam, in which the physician inserts a finger into the rectum to physically check the prostate for enlargement, is the most direct course for verifying prostate enlargement. Further testing can include a blood test to check for kidney problems.
A prostate-specific antigen blood test is another method for diagnosing prostate enlargement. The blood is denser with these antigens when the prostate is enlarged, so they are easy to identify with a blood test. Similar increases can be seen after recent surgeries or in cases of prostate cancer.
Treatment
Many different types of treatment are available for prostate enlargement. A physician can recommend medication or either minimally invasive or more involved surgery. Many factors go into choosing the best course of treatment, including general health, age, the extent of symptoms, and degree of enlargement.
Medication
For mild to moderate symptoms, medication is often the most common treatment. Several different types of medication are effective, including alpha-blockers that relax muscles around the bladder and prostate, medications that shrink the prostate, or a combination of the two.
Minimally Invasive Surgery
When medication doesn’t provide results, minimally invasive surgery is often the next choice. Several procedures involve inserting a scope and small tools through the urethra to reduce the prostate through resectioning, incisions, microwaves, or needle ablation.
Laser Treatment
In some cases, the removal of excess prostate tissue using a high-energy laser is appropriate. This method can relieve symptoms while also reducing the risk of side effects. It is a standard method in cases with other complications, such as patients on blood-thinning medications.