What Are Causes Of An Enlarged Prostate
Benign prostatic hyperplasia occurs mostly in older menEnlarged prostate symptoms generally appear after age 40. In fact, BPH or enlarged prostate can affect about half of men ages 51 to 60, according to the National Institutes of Health .
Experts arent really sure what exactly causes an enlarged prostate, but because it occurs mainly in older men, they believe it may be due to hormone changes. For instance, as guys age, they tend to produce less testosterone, giving them a higher percentage of estrogen. Its possible this can trigger prostate growth.
Its also possible that an accumulation of the hormone dihydrotestosterone or DHT, which can continue even after testosterone levels dip, can make your prostate cells continue to grow, the NIH says.
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.
How Is Yale Medicines Approach To Treating Enlarged Prostate Unique
“Urologists at Yale Medicine can give you a personalized approach to prostate care for both benign and malignant conditions,” says Dr. Honig.
Doctors at Yale Medicine work closely with specialists across all disciplines at Yale New Haven Hospital. Our doctors are dedicated to providing the latest treatmentsall personalized to meet the needs of each patient. This collaboration between different departments and teams sets Yale Medicine apart in its standard of care.
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When To Contact A Medical Professional
- Less urine than usual
- Back, side, or abdominal pain
- Blood or pus in your urine
Also call if:
- Your bladder does not feel completely empty after you urinate.
- You take medicines that may cause urinary problems, such as diuretics, antihistamines, antidepressants, or sedatives. DO NOT stop or change your medicines without talking to your provider.
- You have tried self-care steps for 2 months and symptoms have not improved.
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At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.
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The Difference Between Prostate Cancer And Bph
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Both prostate cancer and benign prostatic hyperplasia can cause an enlarged prostate, but beyond causing common symptoms, the similarities end there.
During your yearly physical, your doctor might do a rectal exam or request you get a blood test to check your prostate-specific antigen level checked. If your prostate is enlarged or your PSA test comes back high, your doctor may do a biopsy to determine if your abnormal results are caused by prostate cancer or BPH. Here’s what you need to know about the two conditions and their similarities and differences.
What Are Enlarged Prostate Treatments
There are a wide variety of strategies for getting that prostate gland back to normal, according to Dr. Ramin. In less severe cases, he notes, it may be enough to limit coffee, tea, and sodacaffeine can stimulate the bladder and increase urinary frequency, which might be putting stress on the prostate.
In slightly more advanced situations, medications like alpha blockerswhich relax muscles in your bladder and prostate to make peeing easier, and alpha reductase inhibitors, which can shrink prostate growth, may be needed.
There are also minimally invasive treatment options like microwave therapy, Dr. Ramin says. In other cases, you may need to undergo resection of the prostate through laser therapy.
For markedly enlarged prostates, patients may need a robotic subtotal prostatectomy procedure.
The best treatment option really depends on a particular patients symptoms and results of testing, says Dr. Ramin. Not every patient with enlarged prostate is created equal, and not every treatment option is a good option for all patients.
So talk to your doctor about whats right for you. Just dont ignore the issue: Untreated enlarged prostate can lead to issues like incontinence, blood in your urinedue to inflammation from straining to peeand eventually, youre at risk for kidney damage, says Dr. Ramin.
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Prostatitis Vs Bph Quick Comparison Of Differences And Similarities
- Both BPH and prostatitis are problems with the prostate gland, a gland surrounding the neck of the bladder in males. The prostate gland is responsible for releasing prostatic fluid that helps make up part of the semen.
- The normal prostate gland is about the size of a walnut. As it increases in size, for whatever reason, it can press on the urethra and cause urinary problems.
- Both prostatitis and BPH can result in an enlarged prostate.
- Most men over 50 years old have some prostate enlargement with no symptoms, while bacterial prostatitis usually occurs in men younger than 35 years old and non-infectious prostatitis occurs in older men.
- You can have either BPH or prostatitis, and have no signs or symptoms. Nevertheless, both can cause pain .
- Prostatitis is caused by infections or other related health problems, while doctors dont know exactly what causes an enlarged prostate, but they think it may be related to hormones.
- BPH can be treated but not cured, but prostatitis is curable in many patients. The large majority of men with prostatitis have an infection of the prostate gland, while those with BPH do not have an infection.
What Are Common Prostate Problems What Are The Symptoms And Signs
Here are some examples of non-cancer prostate problems:
Benign prostatic hyperplasia, or BPH, means your prostate is enlarged, but is not cancerous. It is very common in older men. An enlarged prostate may make it very difficult to urinate or cause dribbling after you urinate. You may feel the need to urinate a lot, often at night. See your family doctor for an exam. Treatments for BPH include:
- Watchful waiting, also called active surveillance. If your symptoms are not too bad, your doctor may tell you to wait before starting any treatment to see if the problem gets worse. Your doctor will tell you how often you need to return for checkups. You can start treatment later if your symptoms worsen.
- Medications. There are medicines that can help shrink the prostate or help relax muscles near your prostate to ease your symptoms. Talk with your doctor about possible side effects.
- Surgery. If nothing else has worked, your doctor may suggest surgery to help urine flow. There are many types of BPH surgery. Talk with your doctor about the risks. Regular checkups are important after surgery.
- Other treatments. Sometimes radio waves, microwaves, or lasers are used to treat urinary problems caused by BPH. These methods use different kinds of heat to reduce extra prostate tissue.
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What Are The Symptoms Of Enlarged Prostate
When the prostate becomes enlarged, it can block the urethra and impair bladder function. Symptoms that may indicate this is happening include:
- Urinating many times a day and being unable to hold off urination
- Problems starting a urine stream or a weak or interrupted stream, followed by dribbling at the end
- Waking at night to urinate and accidental loss of urine
How Your Doctor Can Help
If you have one or more of these symptoms, its important to talk with your doctor about a treatment plan. Treatments for BPH include medication, minimally invasive therapies, and surgery. You can also try lifestyle changes to control symptoms. And sometimes the symptoms get better even without treatment, according to the Mayo Clinic. The best news? Although they can produce similar symptoms, enlarged prostate has no connection to prostate cancer.
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How Is Enlarged Prostate Treated
Treatments for enlarged prostate include:
Lifestyle changes: These can include reducing liquid intake, bladder training , abstaining from alcohol and caffeinated beverages and regularly exercising the pelvic muscles.
Medication: A class of medication called Alpha Blockers works to relax muscle fibers in the prostate and bladder. This relaxation allows for increased urine flow and less frequent urination. A second class of medication, called Alpha Reductase Inhibitors, works to block the hormones that cause the prostate to swell. Many patients will take a combination of these two types of medication.
Minimally invasive procedures: Our specialists are trained in two minimally invasive procedures that can help remove or reduce the obstructing prostate tissue:
Surgery: For severe cases of a very enlarged prostate, surgical removal of the prostatecalled transurethral resection of the prostate may be the recommended course of action. Patients will decide with their doctor if aggressive treatment is warranted, depending on the size of the prostate and severity of symptoms.
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.
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What Is The Prostate Gland
The prostate is a gland about the size of a walnut. It is part of the male reproductive system and wraps around the tube that carries urine out of the bladder. It grows larger as you get older. If your prostate gets too large, it can cause health issues. Having prostate problems does not always mean you have cancer.
Sometimes a doctor may find a problem during a routine checkup or by doing a rectal exam. If you think there is something wrong with your prostate, see your doctor right away.
When Should I Call A Doctor
Your symptoms may not bother you too much. But itâs important to talk over any urinary problems with your doctor.
Itâs hard to predict how BPH will play out, and you canât assume that the problem will get better on its own. Your doctor also will want to rule out things that cause similar problems.
Some symptoms need quick medical attention. If you have any of these, call your doctor right away or head to an emergency room:
- You canât urinate at all.
- You have to pee frequently, itâs painful, and you have fever and chills.
- You have blood in your urine.
- You feel a great deal of pain in your lower belly and urinary tract.
National Institutes of Health: National Institute of Diabetes, Digestive and Kidney Diseases — Prostate Enlargement: Benign Prostatic Hyperplasia.
Cleveland Clinic: Diseases and Conditions — Benign Prostatic Enlargement .
Johns Hopkins Medicine Health Library: Benign Prostatic Hyperplasia.
Mayo Clinic: Diseases and Conditions — Benign Prostatic Hyperplasia .
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What Are The Signs And Symptoms Of An Enlarged Prostate
An enlarged prostate is the most common cause of urinary problems in men as they get older. Possible symptoms include:
- a weak flow when you urinate
- a feeling that your bladder hasnt emptied properly
- difficulty starting to urinate
- dribbling urine after you finish urinating
- needing to urinate more often, especially at night
- a sudden urge to urinate you may sometimes leak before you get to the toilet.
You may not get all of these symptoms, and some men with an enlarged prostate dont get any symptoms at all. These symptoms can also be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicines. Blood in your urine may be a symptom of an enlarged prostate. But this is rare and is usually caused by something else.
If you have any of the symptoms above, you should visit your GP to find out what may be causing them.
What Are The Signs Of An Enlarged Prostate
In many cases, that tubular opening of your prostate becomes tight and constricted when your gland enlarges. This leads to a restricted flow of urine. So, difficulty peeing is the most common sign of prostate problems, Dr. Ramin says.
In 2017, the American Urological Association created a seven-question symptom index for severity benign prostatic hyperplasia. How you answer themoptions include not at all,less than 1 time in 5,less than half the time,about half the time,more than half the time, and almost alwayscan help your doctor evaluate you.
The full questionnaire from the AUA is available here, but the symptoms include the following:
1. The sensation of not emptying your bladder when youre finished peeing
2. The need to pee again less than two hours after you finished urinating
3. Stopping and starting again several times when you urinated
4. The difficulty to postpone urination
5. Having a weak stream of urine
6. The need to push or strain to start to pee
7. Waking up often at night to pee
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How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia , or benign prostatic hypertrophy, is an enlargement of the prostate, a walnut-sized gland that forms part of the male reproductive system. During ejaculation, the prostate secretes fluid into the urethra, the narrow tube that runs through the center of the prostate. When a man urinates, the bladder squeezes urine out through the urethra.
As a man ages, the prostate can become enlarged. Because it surrounds the urethra right at the bladder exit, the prostate may squeeze or pinch the urethra as it gets larger over time. This may cause difficulty with urination such as a slow stream, the need to strain, increased frequency, urgency to urinate, incomplete emptying of the bladder, and intermittent flow or dribbling.
BPH is the most common disorder of the prostate gland and the most common diagnosis by urologists for males between the ages of 45 and 74. More than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
Although research has yet to pinpoint a specific cause for BPH, theories focus on hormones and related substances like dihydrotestosterone , a testosterone derivative in the prostate that may encourage the growth of cells.
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