Enlarged Prostate

Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — can cause uncomfortable urinary symptoms in older men, such as blocking the flow of urine out of the bladder. It can also cause problems with the bladder, urinary tract, or kidney.

Patients diagnosed with BPH may be treated with medications, minimally invasive therapies, or surgery. To determine the best treatment option for the patient, the physician will consider the severity of symptoms, the size of the prostate, other pre-existing health conditions, and treatment preferences.

Patients with BPH may have mild or severe symptoms, however symptoms tend to gradually worsen over time. Common signs of BPH include:

• Frequent or urgent need to urinate
• Frequently urinating at night (nocturia)
• Difficulty starting urination
• Weak urine stream or a stream that stops and starts
• Dribbling at the end of urination
• Inability to completely empty the bladder

Less common signs and symptoms include:

• Urinary tract infection
• Inability to urinate
• Blood in the urine

The size of the prostate won’t impact the severity of symptoms. Some men with only slightly enlarged prostates may experience severe symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

In some men, symptoms eventually stabilize and might even gradually improve.

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

• Urinary tract infection
• Inflammation of the prostate (prostatitis)
• Narrowing of the urethra (urethral stricture)
• Scarring in the bladder neck as a result of previous surgery
• Problems with nerves that control the bladder
• Bladder or kidney stones
• Cancer of the prostate or bladder

The prostate gland is located beneath the bladder. The urethra transports urine from the bladder out of the penis and passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.

The prostate naturally grows throughout life. In some cases, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

The exact cause of prostate enlargement is unclear. However, it might be due to changes in the bodies’ responsiveness to sex hormones as men age.

• Aging. Prostate gland enlargement rarely causes signs and symptoms in men under 40. About one-third of men experience moderate to severe symptoms by the time they turn 60, and about half do so by age 80.
• Family history. Patients are at increased risk if they have a blood relative, such as a father or a brother, with prostate problems.
• Diabetes and heart disease. Conditions such as diabetes and heart disease, as well as the use of beta blockers might increase the risk of BPH.
• Lifestyle. Obesity increases the risk of BPH, while exercise can lower risk.

Depending on the patient’s unique condition, treatment for BPH may include:

• Alpha blockers
• 5-alpha reductase inhibitors
• Combination drug therapy
• Tadalafil (Cialis)
• Transurethral resection of the prostate
• Transurethral incision of the prostate
• Transurethral microwave thermotherapy
• Transurethral needle ablation
• Laser therapy
• Prostatic urethral lift
• Embolization
• Robot-assisted prostatectomy

Patients diagnosed with an enlarged prostate (BPH) should schedule an appointment with Dr. David Lee for diagnosis and treatment.