Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
How Is Bph Treated
In some cases, in particular where symptoms are mild, BPH requires no treatment. At the opposite extreme, some men require immediate intervention if they cannot urinate at all or if kidney/bladder damage has occurred. When treatment is necessary, many men will simply require daily medication. If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend minimally invasive;endoscopic surgery . Or, in some cases, traditional surgery may be recommended.
- Drug treatment: The FDA has approved several drugs to relieve common symptoms associated with an enlarged prostate, including drugs that inhibit the production of the hormone DHT and drugs that relax the smooth muscle of the prostate and bladder neck to improve urine flow.
For surgery, there are many procedures to choose from, and the choice depends largely on your specific prostate anatomy, and surgeon preference and training. These procedures all have a common goal of widening the urethral channel as it passes through the prostate. Procedures include the following:
What Other Problems Might An Enlarged Prostate Cause
A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:
- youre aged 70 or over
- your prostate is very large
- you have a raised;prostate specific antigen ;level
- you have severe urinary symptoms and a very slow flow.
Chronic urine retention
This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.
Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.
There are treatments for chronic urine retention, including:
- passing a thin, flexible tube called a catheter to drain urine from your bladder
- surgery to widen the urethra.
Acute urine retention
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The Most Common Prostate Problem Among Men Over Age 50 This Condition Can Cause Embarrassing Urination Issues
While BPH does not increase your risk of getting prostate cancer or having sexual problems, it can affect quality of life, specifically by causing annoying and embarrassing urination problems.
“Since prostate enlargement happens gradually, men often think more frequent trips to the bathroom are a natural part of aging,” says Dr. Howard LeWine, chief medical editor at Harvard Health Publishing and an assistant professor of medicine at Harvard-affiliated Brigham and Women’s Hospital. “But a little medication can help relieve symptoms, meaning less urinary urgency and fewer nighttime awakenings to use the bathroom.”
If You Are Diagnosed With Bph
Taken together, these tests will help your doctor determine whether you have BPH;and if you do, how severe it is. If you have BPH, your doctor should provide you with information on whether simply monitoring your symptoms is a reasonable option, or whether treatment is a better option.
BPH can be treated medically or surgically in some cases.
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What Is Enlarged Prostate
Enlarged prostate refers to the state in which the prostate is enlarged;but not cancerous.
Hormonal changes and cell growth resulting from the aging process may cause the prostate to swell, often impinging upon and compressing the urethra. This causes the bladder walls to become thicker and can prevent the bladder from emptying completely.
What Is An Enlarged Prostate
The prostate is a small gland, usually about the size of a walnut, that is situated just below the bladder and above the penis. The urethra passes through the prostate, which produces fluid that is mixed with sperm to create semen. When the prostate enlarges, it places pressure on the bladder and the urethra, which can cause urinary problems.
The prostate is made up of four zones:
- Peripheral zone. The area most easily felt during the standard digital rectal exam and the zone from which prostate cancer tends to develop.
- Transition zone. This surrounds the part of the urethra that passes through the prostate. It enlarges as men age, causing benign prostatic hyperplasia and consequent urinary symptoms.
- Central zone
- Anterior fibromuscular stroma
The prostate can become enlarged for a variety of reasons. The most common are:
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What Is Prostate Cancer
Prostate cancer is common among American men. Your chance of getting prostate cancer may be affected by your:
- Age. Men age 50 and older run a greater risk.
- Race. Prostate cancer is most common among African-American men.
- Family history. If your father or brother has had prostate cancer, you are more likely to have it, too.
- Diet. Eating high-fat food with few fruits and vegetables may raise your risk.
Treating Benign Prostate Enlargement
Treatment for an enlarged prostate is determined by the severity of your symptoms.
If you have mild to moderate;symptoms, you wonât receive any immediate medical treatment, but youâll have regular check-ups to carefully monitor your prostate.
Youâll probably also be advised to make;lifestyle changes, such as limiting your caffeine and;alcohol intake, and exercising regularly,;to see if they improve your symptoms.
As well as;lifestyle changes, medication is usually recommended to treat moderate to severe symptoms of benign prostate enlargement.;Finasteride and dutasteride are medications;that are commonly used. They block the effects of a hormone called dihydrotestosterone on the prostate gland, which can reduce the size of the prostate and improve associated symptoms.
Alpha blockers may also be prescribed. They help to relax your bladder muscles, making it easier to pass urine. Tamsulosin and alfuzosin are two alpha blockers commonly used to treat benign prostate enlargement.
Surgery is usually only recommended for moderate to severe symptoms of benign prostate enlargement that have failed to respond to medication.
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Initial Tests For Bph
- A urine test will rule out any infection or another issue.
- A PSA blood test looks for levels of a Protein Specific Antigen found only in the prostate gland. This protein should be at a low level for a healthy prostate. Higher levels can indicate an inflammation known as prostatitis, BPH, or prostate cancer. This is a routine test for men over age 50.
- A DRE is a digital rectal exam performed by the doctor using a lubricated glove. As the man bends forward or lies on his side, the doctor inserts one finger into the rectum to feel the prostate and determine if it has an abnormal shape or thickness.
Some additional tests may be ordered. Among them are a uroflowmetry test, measuring how fast the urine flows, a PVR or post-void residual test to determine how much urine is left in the bladder after urination, and an ultrasound of the prostate, plus others.
Sign : Frequent Urge To Urinate
You feel sudden urges to go anytime, even if you have little or no urine in your bladder. The urge may be so strong that you feel like you cant hold it until youre in the bathroom.
These urges can significantly impact your life. If you wake up to go 2-3 times or more per night because of them, you could suffer from fatigue, loss of focus, moodiness, and lack of energy.
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How To Reduce Prostate Size
This article was medically reviewed by . Dr. Litza is a board certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.There are 13 references cited in this article, which can be found at the bottom of the page. This article has been viewed 65,131 times.
The prostate gland is a part of the male reproductive system that can enlarge with age, putting uncomfortable pressure on the urethra. This can cause urinary difficulties, urinary tract infections , and even bladder stones. By making lifestyle changes and using medication, most men can reduce their urinary troubles. A few men, though, may need to consider minimally invasive or traditional surgery options to feel their best.
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have;treatment.
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What Tests Might I Have At The Hospital
If youre given an appointment with a hospital specialist, they may do some of the tests you had at the GP surgery again. You may also have other tests, including the following.
Symptom questionnaire
You might be asked to fill in a short questionnaire about your symptoms. This is called the International Prostate Symptom Score and is used to see how bad your symptoms are and how much they are bothering you.
Urine flow test
Youll be asked to urinate into a machine that measures the speed of your urine flow. Men with an enlarged prostate usually have a slower flow than other men. Youâll need a full bladder for the test. The doctor or nurse will tell you how much to drink before you have the test. They may also ask you not to urinate for two to three hours before the test.
Ultrasound scan
This shows how much urine your bladder can hold, and if it is emptying properly. You may have the scan straight after the urine flow test to see how much urine is left in your bladder after you urinate. You may also have an ultrasound scan to look at your kidneys.
Symptoms Of Benign Prostate Enlargement
The;prostate is a small gland, located in the pelvis, between the penis and bladder.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
This can;affect how you pee and may cause: ;
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
In some men, the symptoms are mild and do not need treatment. In others, they can be very troublesome.
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When To Seek Medical Advice
See;a GP if you have any of;the symptoms of an enlarged prostate .
Even if the symptoms are mild, they could be caused by a condition that needs to be investigated.
Any;blood in your urine must be investigated by a GP to rule out other more serious conditions.
Page last reviewed: 10 February 2020 Next review due: 10 February 2023
Minimally Invasive Treatments For An Enlarged Prostate
When medications don’t help your enlarged prostate, several procedures can relieve symptoms — without surgery. They are performed in a doctor’s office. “These procedures use various types of heat energy to shrink a portion of the prostate,” explains Westney. “They are very effective.”
TUMT : This therapy for mild to moderate blockage reduces urinary frequency, urgency, straining, and intermittent flow — but does not correct any bladder-emptying problems. In this procedure, computer-regulated microwaves are used to heat portions within the prostate to destroy select tissue. A cooling system protects the wall of the urethra during the procedure. TUMT is performed in a doctor’s office and requires only topical anesthesia and pain medications.
Possible side effects include painful urination for several weeks. Temporary urgency and frequency of urination is also possible. There may be less semen ejaculated. Many men must have this procedure repeated, either because symptoms return or do not improve.
TUNA : This procedure also destroys prostate tissue to improve urine flow and relieve symptoms. It involves heating the tissue with high-frequency radiowaves transmitted by needles inserted directly into the prostate . The procedure does not require a hospital stay. Possible side effects include painful, urgent, or frequent urination for a few weeks.
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With A Massager Strap
If youre playing with sex toys, you can really mix it up by playing with the different vibration settings, as well as pressure and depth.
- Pressure. Controlling pressure when using a toy is easier, especially when youre playing solo. Try pressing the toy against the prostate using more or less pressure till you find your sweet spot.
- Depth. Depth is another area where toys win out since reaching can make it hard to go deep, if thats what you crave. Try different sized anal toys or get a longer one that you can insert as deep as your bottom desires.
- Vibrations. You can buy prostate massagers that offer up multiple speed and pulse settings. Play with the different settings to find your preference. Up the vibes as you get closer to orgasm.
- Sensation. Some prostate massagers have an attached external stimulator to give your perineum some sweet lovin while the other end penetrates. Who doesnt love a hard worker?
Want a little more?
If your partner has a penis, you can kick things up a notch with penis-in-anus penetration. Prostate stimulation for you, penile stimulation for them and a happy ending for you both.
Different positions can make reaching and pleasuring the prostate easier. These positions work for external and internal prostate stimulation, alone and with a partner.
Risk Factors For Prostate Cancer
Some risk factors have been linked to prostate cancer. A risk factor is something that can raise your chance of developing a disease. Having one or more risk factors doesnât mean that you will get prostate cancer. It just means that your risk of the disease is greater.
- Age. Men who are 50 or older have a higher risk of prostate cancer.
- Race. African-American men have the highest risk of prostate cancerâthe disease tends to start at younger ages and grows faster than in men of other races. After African-American men, prostate cancer is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer.
- Family history. Men whose fathers or brothers have had prostate cancer have a 2 to 3 times higher risk of prostate cancer than men who do not have a family history of the disease. A man who has 3 immediate family members with prostate cancer has about 10 times the risk of a man who does not have a family history of prostate cancer. The younger a manâs relatives are when they have prostate cancer, the greater his risk for developing the disease. Prostate cancer risk also appears to be slightly higher for men from families with a history of breast cancer.
- Diet. The risk of prostate cancer may be higher for men who eat high-fat diets.
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Surgery For An Enlarged Prostate
For most men with very enlarged prostates, surgery can relieve symptoms — but there are both risks and benefits with each type of operation. Discuss them with your doctor. After a careful evaluation of your situation and your general medical condition, your doctor will recommend which is best for you.
TURP : This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.
With the TURP procedure, patients can expect to have retrograde ejaculation afterwards, says Westney. This is a condition in which a man ejaculates backward into the bladder instead of through the urethra. “Retrograde ejaculation generally isn’t painful,” she tells WebMD. “It shouldn’t be an issue unless fertility is a concern.” Other possible side effects include blood loss requiring transfusion , painful urination, recurring urinary tract infections, bladder neck narrowing, and blood in the urine.
After TURP, the odds of erection problems range from 5% to 35%. However, this is often temporary — and the ability to have an erection and an orgasm returns after a few months.