For young men, the prostate usually doesn’t cause any problems. However, as men age, the prostate gradually gets larger, and some men develop a condition called benign prostatic hyperplasia (BPH), or an enlarged prostate. Although BPH is generally not a serious condition, it can cause bothersome symptoms. Fortunately, treatments can help.
Read More: Difficulty Urinating and Other Signs of Prostate Problems
What Causes an Enlarged Prostate?
BPH mostly affects older men. About 50% of men ages 51 to 60 and up to 90% of men over age 80 have symptoms of BPH. Experts aren’t sure exactly what causes the condition, but it may be related to hormonal changes that occur as men age.
A hormone called dihydrotestosterone (DHT) in particular may play a role. DHT is responsible for certain male traits, such as facial hair and prostate growth. Older men may have high levels of DHT, which could lead to continued prostate growth.
Other factors besides hormones can increase the likelihood of a man developing BPH. Those factors include:
- Being age 40 or older
- Certain medical conditions, such as obesity, heart disease and Type 2 diabetes
- Erectile dysfunction
- A family history of BPH
- Lack of physical activity
Identifying the Symptoms of an Enlarged Prostate
Urinary issues are common in many men with an enlarged prostate. As the prostate gets bigger, it presses against the urethra, the tube through which urine flows out of the bladder. Over time, the bladder muscles can get weaker, and you might not be able to empty your bladder completely.
Other symptoms of BPH can include:
- Frequent urination, defined as urinating eight or more times per day and having to urinate frequently while sleeping
- Having urine with an unusual smell or color
- Pain when urinating or after ejaculation
- Trouble starting a urine stream or having a weak urine stream
- Urinary urgency, or being unable to delay urinating
- Urinary incontinence, or being unable to control your urine
- Urinary retention, or the inability to completely empty your bladder
What to Do If You Have Symptoms of BPH
“You may be tempted to ignore symptoms, especially if they are only mild,” says Dr. Louis Plzak, III at Beaufort Memorial Urology Specialists. “However, BPH may increase the risk of developing urinary tract infections, acute urinary retention (inability to urinate), bladder stones and kidney damage.” In addition, although BPH does not increase the risk of getting prostate cancer, its symptoms can mimic those of prostate cancer, so it’s important to see a provider if you experience them.
Your provider will talk to you about your personal and family medical history and ask questions about:
- What symptoms you have and how often they occur
- Whether you have a history of urinary tract infections
- What medications you take
- How much water you drink and whether you consume a lot of caffeine or alcohol
- What other medical conditions you have
Your provider may also perform a physical exam and a digital rectal exam, which is a physical exam of the prostate.
A review of your symptoms and a physical exam are usually enough for a diagnosis of BPH. However, your provider may refer you to a urologist, who might perform other tests, including:
- A urinalysis — A urine sample will be evaluated for signs of infection.
- Prostate-specific antigen (PSA) blood test — This test shows levels of PSA in the blood. High levels can indicate BPH or another problem with the prostate, such as an infection or prostate cancer.
- Urodynamic tests — These tests help the urologist determine how well the urethra and bladder store and release urine from the body.
- Cystoscopy — For this procedure, a urologist inserts a narrow tube called a cystoscope into the penis to evaluate the urethra and bladder.
- Transrectal ultrasound — A type of imaging exam that uses sound waves, this test involves a trained technician inserting a wand into the rectum and taking images of the prostate. Your urologist will review the images to see the size of the prostate and look for abnormalities.
Read More: Prostate Cancer Screenings: The Facts
Managing BPH
You may not require medical treatments if symptoms do not bother you. Instead, your provider may recommend lifestyle changes, such as:
- Avoiding caffeine and alcohol as well as certain medications, such as decongestants and antidepressants
- Doing pelvic floor exercises
- Reducing intake of liquids, especially before going to bed or going out in public
If your symptoms affect your quality of life, your doctor can prescribe medications that may help. Medications can relax your prostate and bladder muscles or improve urine flow, so you can reduce symptoms related to urination. Other medications can shrink the prostate or treat erectile dysfunction.
Treating BPH
When medication and lifestyle changes are not enough, your urologist might recommend a minimally invasive procedure or surgical treatment to reduce the size of the prostate or widen the urethra.
Minimally invasive procedures allow surgeons to treat BPH without the side effects that can accompany traditional BPH surgeries. These procedures may involve heat, electric currents or microwaves that destroy prostate tissue using special tools inserted through the urethra or rectum, avoiding the need for incisions.
The downside to minimally invasive treatments is that they don’t always provide a permanent solution. Long-term solutions typically require surgery. The most common surgical treatment for an enlarged prostate is called transurethral resection of the prostate (TURP), in which a urologist inserts an instrument into the urethra to remove pieces of enlarged prostate tissue. The tissue pieces are flushed out through the bladder at the end of the procedure. Side effects of surgery can include problems with urination, bleeding, infection and sexual dysfunction. Many side effects are temporary. Some men require another surgical procedure to correct an enlarged prostate within five years.
Your urologist will help you decide on the best treatment for you. The bottom line, however, is that BPH is treatable, and you have many options to choose from, so you can live without symptoms and get back to enjoying your life.
Do you have symptoms of an enlarged prostate? Find a primary care provider at Beaufort Memorial who can help.
