An enlarged prostate also medically called Benign Prostatic Hyperplasia (BPH) is a common medical condition in men, where their prostate – small, muscular gland in the male reproductive system – becomes enlarged with age. The prostate surrounds the urethra and makes semen, which is propelled along with the fluid through the penis during sexual climax. The enlarged prostate can cause symptoms and also complications over time, though it is medically treatable.
Causes of an Enlarged Prostate
BPH or enlarged prostate is considered normal in ageing men, especially men above 50 years of age. The exact cause of the condition is not known but changed in sexual hormones with age contribute towards the condition. Also, an enlarged prostate is caused when the prostate gland cells begin to multiply, causing pressure on the urethra and making the gland swell, resulting in squeezing of the urethra. The narrowed urethra leads to restricted flow of urine from the body and also causes the bladder to contract more forcefully to excrete the urine. Men with a family history of prostate problems or abnormalities are at higher risk of developing an enlarged prostate.
However, an enlarged prostate is not the same as prostate cancer, nor does it necessarily increase the risk of prostate cancer. But the symptoms of the problem can majorly impact the quality of life and hence, must be medically treated.
Risk Factors of an Enlarged Prostate
Most men continue to have prostate growth throughout their lives, which can cause an enlarged prostate. Though it cannot be fully justified as a single cause, some factors which put one at more risk than others for developing an enlarged prostate include:
Increasing age: Men lower than 40 years of age do not experience this problem; however, men above 40 and mostly above 50 are at a higher risk of developing an enlarged prostate.
Family history: Men who have a family history of prostate problems, especially a blood relative – are at a higher risk than others.
Diabetes and heart problems: As per researches, it is believed that men with diabetes or a heart problem/disease are more prone to a BPH.
Lifestyle: A sedentary lifestyle increase the risk of an enlarged prostate, while an active lifestyle involving healthy weight management, physical exercise, etc. can lower the risk of the problem in men.
Symptoms of an Enlarged Prostate
An enlarged prostate increase with age and might not have any significant symptoms at first. However, these tend to aggravate with age or if medical treatment is delayed.
Some common symptoms include:
- Incomplete emptying of the bladder
- Nocturia – a condition which causes the person to urinate more than two times at night
- Leakage of urine or incontinence
- Sudden, uncontrollable urge to urinate
- Blood in urine
- Frequent urination
- Pain while urinating
- A weak urinary system
- A delayed urinary stream
- Feeling the need to strain while urinating
- Dribbling at the end of urination
- A urinary stream which starts and drops
- Returning to urinate even after minutes of finishing the first round
An enlarged prostate does not let the bladder empty itself completely and hence, there is a risk of urinary tract infections, while other serious issues can also affect the patient such as bladder stones, inability to urinate, etc. In rare and severe cases, such problem especially complete inability to urinate can cause kidney or bladder damage.
Treatment of Enlarged Prostate
Enlarged prostate or a BPH is a very common medical condition and can be treated with a variety of methods, including simple medications, minimally invasive surgeries or therapies. The choice of the method depends on factors such as:
- Size the prostate
- Overall health condition
- Level of discomfort or problem
In case, the symptoms are mild, doctors might recommend monitoring the condition and following basic lifestyle modifications to ease the problem without any medical treatment.
In cases, where the symptoms experienced are mild or moderate, the doctor will recommend certain medications such as:
- Combination drug therapy
Minimally invasive surgery or surgical therapy
Minimally invasive surgery will be an ideal choice of treatment in conditions where:
- The symptoms are moderate to severe
- Medications have failed to provide relief
- The enlarged prostate has caused bladder stones, urinary tract obstruction, blood in urine, etc.
But for patients, who have the following conditions, minimally invasive surgery may not be a treatment option.
- An untreated urinary tract infection which has worsened with time
- Urethral stricture disease
- A history of urinary tract surgery, radiation therapy, or other similar medical treatment
- A neurological problem
- Multiple sclerosis or other grave health condition
There are several types of minimally invasive surgical treatment such as:
- Transurethral microwave thermotherapy (TUMT)
- Transurethral needle ablation (TUNA)
- Laser therapy
- Water-induced thermotherapy (WIT)
- High-intensity focused ultrasonography (HIFU)
In cases, where minimally invasive surgical procedures fail or do not fit per the patient’s condition, following surgical procedures may be recommended:
- Transurethral resection of the prostate (TURP)
- Simple prostatectomy
- Transurethral incision of the prostate (TUIP)
Overall, an enlarged prostate may not always require a medical treatment provided the symptoms are mild and the condition is regularly monitored through tests suggested by the doctor. However, in cases, where symptoms are severe and there are existing health conditions, adequate and timely treatment becomes critical to avoid complications.