The 4 Causes Of An Enlarged Prostate
It is normal for a prostate to become enlarged as a man ages. The prostate is approximately the size of a walnut in younger men but can grow to be much larger as they get older. An enlarged prostate can cause no visible symptoms but will eventually impact urinary and erectile functions if not properly treated.
There are many reasons a prostate gets enlarged, and most of them arent cancerous. Here are the most common:
What Procedures Or Tests Diagnose This Prostate Problem
A doctor or other health care professional usually can detect an enlarged prostate by rectal examination. A medical professionals may perform a rectal examination to ensure that there are no “nodules,” which are hard, irregular areas in the prostate suspicious for prostate cancer, as well as to assess the size of the prostate. Assessment of prostate size and shape is better assessed with an abdominal or transrectal ultrasound or cystoscopy. A cystoscope is a long, thin telescope-like instrument that has a light source and lens allowing one to look at the urethra, the prostate, and the bladder when inserted through the opening at the tip of the penis. Cystoscopy and/or ultrasound is recommended prior to surgical treatment of BPH. Other tests that medical professionals may perform include: bladder scanner postvoid residual determination and uroflowmetry . Lastly, a PSA is often obtained and if abnormal may require further evaluation to rule out prostate cancer.
The American Urological Association recommends that men with BPH complete the AUA-symptom index , which assesses the degree to which symptoms bother. It is a useful way to assess changes in bothersome symptoms with treatment.
Symptoms Of An Enlarged Prostate
As mentioned above, the most common symptoms of an enlarged prostate are urination problems. Its because the prostate portion surrounding the urethra narrows the normal passage of urine. These problems become worse as the patient gets older.
The progression prolongs which some patients may not even realize. They learn to live with the symptoms and sometimes wont even report them. However, it is crucial to recognize the symptoms of an enlarged prostate and consult your doctor.
Heres a list of the most important symptoms .
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Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
Can An Enlarged Prostate Be Cured
An enlarged prostatealso referred to as benign prostatic hyperplasia is a common condition among men as they grow older. It is characterized by the natural enlargement of the prostate, a small gland situated between the bladder and penis. The urethra, or the tube that carries urine from the bladder to the penis, is surrounded by the prostate, and often becomes squeezed and compressed as a result of prostate enlargement. This can cause a weakened urine stream and related issues like a frequent urge to urinate and difficulty sleeping through the night.
Prostate enlargement tends to come with age. While its difficult to completely reverse an enlarged prostate, there are several treatments that can relieve symptoms, reduce the size of the prostate and help restore normal urine flow. In fact, many men with prostate enlargement are able to achieve a positive quality of life with non-surgical treatments.
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What Is The Prostate Gland
The prostate is a small organ about the size of a walnut. It lies below the bladder and surrounds the urethra . The prostate makes a fluid that helps to nourish sperm as part of the semen .
Prostate problems are common in men 50 and older. Most can be treated successfully without harming sexual function.
What Causes Bph At What Age Do Men Develop The Condition
Medical professionals do not have a good understanding of what causes an enlarged prostate.
BPH generally begins in a man’s 30s, evolves slowly, and most commonly only causes symptoms after 50.
In benign prostatic hyperplasia, the prostate gland grows in size. It may compress the urethra, which courses through the center of the prostate. This can impede the flow of urine from the bladder through the urethra to the outside. Lower urinary tract symptoms from BPH can be due to one of the factors: dynamic, static, and compensatory. Dynamic factors are related to the tone of the muscle surrounding the prostate and the outlet of the bladder whereas static factors are related to the enlargement of the prostate tissue. Dynamic and static symptoms are prostate-related symptoms. Compensatory factors are the result of changes that occur in the bladder as a result of the bladder working harder to push urine past the bladder neck and prostate.
Signs and symptoms of BPH include lower urinary tract symptoms of weak urine stream, difficulty starting the urine stream , straining to urinate, inability to completely empty the bladder, inability to urinate , blood in the urine , leakage of urine , decreased urine flow , and post-void dribbling of urine.
BPH may also be related to the development of bladder stones, recurrent urinary tract infections, and backup of urine in the kidneys .
What Is Bph And How Does It Affect Me
The prostate gland surrounds the urethra and assists in reproduction. As a man ages, the prostate gets larger and begins to put pressure on the bladder and urethra, causing uncomfortable symptoms. It may be responsible for blocking the flow of urine out of the bladder, and can cause issues in the bladder, urinary tract, or kidneys.
When To Get Concerned About An Enlarged Prostate
Common symptoms of BPH involve difficulty beginning to urinate, straining to urinate, dribbling at the end, and a decreased force of the stream. This occurs because the prostate surrounds the urethra and its enlargement will squeeze the urethra making it difficult to urinate.
When symptoms begin to affect your quality of life, it is time to see McIver Clinic. It is time to decide on a treatment that is right for you depending on your age and the severity of your symptoms.
Do not ignore painful or burning urination, painful ejaculation, blood in the urine or semen, frequent pain in the lower back, hips, pelvic or rectal area.
Possible complications from untreated BPH include the following:
- Urinary retention
- Chronic prostatitis causing chronic pelvic syndrome with pain in the lower back, groin, and tip of the penis
- Bacteria infections
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How Is Benign Prostate Enlargement Diagnosed
If your GP suspects that you have an enlarged prostate, youll be asked to complete a questionnaire to assess your symptoms.
Each question has five possible answers that carry a score, and your overall score indicates the severity of your symptoms.
Your GP will also want to rule out other conditions that cause similar symptoms to prostate enlargement.
You may have a number of standard tests, such as urine tests, plus some more specific tests, such as a blood test that measures PSA.
How Doctors Diagnose Enlarged Prostate
A presumptive diagnosis of BPH is based upon taking a history of your symptoms other tests may be used to confirm the diagnosis.
BPH Enlarged Prostate Tests
- A rectal examination to assess the size and shape of the prostate
- Ultrasound examination
- Cystoscopy, in which the doctor can see and evaluate the inside of the bladder
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Dangers Of An Enlarged Prostate
Did you know that as men age, your risk for developing an enlarged prostate increases quickly? By age 55, about 25% of all men will have developed benign prostatic hyperplasia , commonly referred to as an enlarged prostate. By age 60, this number rises to 50%, and by age 85, at least 90% of men have BPH.
Although an enlarged prostate isnt the same as prostate cancer and doesnt increase your risk of developing prostate cancer, that doesnt mean BPH is danger-free. At Alate Health, were committed to providing the safest and most effective treatments for BPH to men in and around Houston, Texas.
Board-certified radiologist Andrew Doe, MD, understands the frustration the symptoms of an enlarged prostate cause and the risks untreated BPH brings. Our team has put together this informative article to help you better understand BPH and the dangers leaving it untreated may cause.
Does Bph Increase Your Risk Of Developing Prostate Cancer
The American Cancer Society recommends that men make an informed decision with their health care provider whether to be screened for prostate cancer. For men at average risk, this discussion should start at age 50. They also say that for men who are at high risk, such as African-American men and men with a family history of prostate cancer, screening should be considered at age 45. Men at an even higher risk, such as having more than one relative with a history of prostate cancer at an early age, should consider earlier testing.
The American Urological Association recommends against routine screening for men age 40 â 54 who have an average risk of prostate cancer. Those with a higher risk are encouraged to discuss prostate cancer screening tests with their doctor. The association recommends that men ages 55 â 69 should weigh the risks and benefits of screening and treatment. For those who choose screening, the AUA suggests that they may be screened every two years rather than annually. Tests used to screen for prostate cancer include a blood test for a substance called prostate-specific antigen and the digital rectal exam . The AUA does not recommend PSA screening in men over age 70 or any man with less than a 10-15-year life expectancy.
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Can Alcohol Increase The Risk Of Developing Enlarged Prostate
Quite the opposite is true!
Current research indicates that consuming alcohol is negatively correlated with the risk of BPH. A meta-analysis from 2009 looked at 19 studies spanning a total of 120,091 male participants who consumed greater than 1.2oz of alcohol a day. This intake was associated with a 35% reduced risk of developing BPH. However, before you get excited about getting a hall pass to indulge, its important to remember the myriad of risks associated with chronic alcohol intake. In the case of urinary concerns and this study, while the risk of BPH dropped, the risk of developing a lower urinary tract infection rose with alcohol consumption.
What Are The Risk Factors For Enlarged Prostate
Researchers are still largely unclear on what causes the prostate to become enlarged but risk factors include:
- Age: As many as 90 percent of men over the age of 80 have an enlarged prostate.
- Family history: Men who have a family history of the condition are more likely to suffer from it.
- Other health issues: Men who suffer from obesity, heart disease, or type 2 diabetes have higher rates of an enlarged prostate diagnoses.
Find Your Bph Symptom Score
The International Prostate Symptom Score is a common method for screening and diagnosing benign prostatic hyperplasia . The survey asks seven urinary symptom questions and one quality of life question to help determine the severity of your BPH.
WebMD does not endorse any specific product, service, or treatment.
Find your BPH Symptom Score in Two Minutes or contact UroLift at .
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What Are The Symptoms Of Benign Prostatic Hyperplasia
Lower urinary tract symptoms suggestive of benign prostatic hyperplasia may include
- urinary frequencyurination eight or more times a day
- urinary urgencythe inability to delay urination
- trouble starting a urine stream
- a weak or an interrupted urine stream
- dribbling at the end of urination
- nocturiafrequent urination during periods of sleep
- urinary incontinencethe accidental loss of urine
- pain after ejaculation or during urination
- urine that has an unusual color or smell
Symptoms of benign prostatic hyperplasia most often come from
- a blocked urethra
- a bladder that is overworked from trying to pass urine through the blockage
The size of the prostate does not always determine the severity of the blockage or symptoms. Some men with greatly enlarged prostates have little blockage and few symptoms, while other men who have minimally enlarged prostates have greater blockage and more symptoms. Less than half of all men with benign prostatic hyperplasia have lower urinary tract symptoms.3
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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.
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.
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.
Medications For Enlarged Prostate
There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors
Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostate’s size, eliminating blockage.
Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.
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How Is An Enlarged Prostate Treated
The treatment plan for an enlarged prostate depends on several factors unique to you. At Alate Health, Dr. Doe considers your age, medical history and overall health, the size of your prostate, and the severity of your symptoms.
Based on your unique condition, he may begin treatment with medication for mild or moderate BPH cases. If your BPH is more severe, Dr. Doe may recommend prostate artery embolization .
PAE is a minimally invasive, cutting-edge modality that uses X-ray technology to treat BPH. During the procedure, youre given a catheter, and Dr. Doe makes a small incision in your groin or wrist to access your blood vessels.
X-ray dye is then injected to allow Dr. Doe to create a map, or arteriogram, of the blood vessels supplying your prostate gland. Once these vessels are mapped, Dr. Doe injects microspheres, or microscopic plastic beads, to slow the supply of blood reaching the prostate.
The catheter is then removed, and the process is repeated on the other side of the prostate gland. When the procedure is complete, your prostate begins to shrink over the following weeks since its blood supply is limited. As it shrinks, your symptoms improve.
Ready to learn more about the dangers of an enlarged prostate and how the team at Alate Health can help? Contact our Houston office or schedule an appointment by calling 713-893-0650 today!
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Other Points To Consider With Enlarged Prostate
Need for repeat procedures: With minimally invasive procedures for an enlarged prostate, there is a chance you will need to have a repeat procedure later on. Having the procedure when youre young makes that a near certainty. However, that may be a risk youre willing to take to avoid surgery in the short term.
Side effects of treatments: Some BPH treatments cause erection problems, although that risk is low. Men who have normal erections before surgery will not likely have trouble afterward. Some treatments cause retrograde ejaculation . Fertility can also be affected, but is still possible with newer assisted reproductive techniques.
Multiple health problems: If you have other health problems, especially if you are on an anticoagulant and cannot stop taking this medication, your treatment options for enlarged prostate may be affected. For example, if you have had surgery for obstructive sleep apnea or pulmonary surgery in the past, having surgery with general anesthesia may be too risky. However, spinal anesthesia may be an option for you. Or you may wish to have a minimally invasive office procedure that doesnt require anesthesia at all.
Talk to your doctor about your BPH symptom score, your concerns, and about the plan of treatment that works best for you.
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