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 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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How Is Benign Prostate Enlargement Diagnosed
If your GP suspects that you have an enlarged prostate, you’ll 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.
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Diagnosing Benign Prostate Enlargement
You might have several different tests to find out if you have an enlarged prostate.
A GP may do some of these tests, such as a urine test,;but others might need to be done at a;hospital.
Some tests may be needed to rule out other conditions that cause similar symptoms to BPE, such as;prostate cancer.
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
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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.
What Are Additional Tests For Detecting Prostate Problems
If the DRE or the PSA blood test indicates a problem may exist, the health care provider may order additional tests, including urinalysis, urodynamic tests, cystoscopy, abdominal ultrasound, transrectal ultrasound with prostate biopsy, and imaging studies such as magnetic resonance imaging or computerized tomography scan.
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Causes Of Benign Prostate Enlargement
The exact cause of benign prostate enlargement is unknown, but research suggests that hormones probably play an important role in the conditions development.
Hormones are powerful chemicals that can have a wide range of effects on the cells of the body.
One theory is that as some men get older, the levels of a type of hormone called dihydrotestosterone increases, which may stimulate the growth of the prostate.
Another theory suggests that two hormones, testosterone and oestrogen, play a role. Younger men produce high levels of testosterone and much smaller levels of oestrogen. But as men get older, their levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. Its been suggested that the relative increase in oestrogen may stimulate prostate growth.
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What Can I Do To Manage Bph
- Urinate on a regular schedule. This will train your bladder to hold urine longer. A larger amount of urine may make it easier to urinate.
- Talk to your healthcare provider about all your medicines. This includes prescription and over-the-counter medicines. Some medicines can make BPH worse. Do not start any new medicines before you talk to your provider.
- Drink less liquid during the day. Do not have liquid for several hours before you go to bed at night. Do not drink large amounts of any liquid at one time.
- Limit alcohol and caffeine. These can irritate your bladder and make your symptoms worse.
- Eat less salt. Salt can cause fluid buildup and make it harder to urinate. Examples of salty foods are chips, cured meats, and canned soups. Do not use table salt.
- Elevate your legs if you have swelling. Elevate your legs above the level of your heart. This can relieve swelling caused by fluid buildup. You may not have to get up in the night to urinate.
- Lose weight if you are overweight. Obesity increases your risk for obstructive sleep apnea . OSA can make you need to get up in the night to urinate. Exercise can help you reach or maintain a healthy weight. A lack of exercise may make BPH symptoms worse. Aim to get at least 30 minutes of exercise on most days of the week.
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.
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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 you’re young makes that a near certainty. However, that may be a risk you’re 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 doesn’t 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.
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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A New Treatment Option For Bph
Experts at University Hospitals now offer a new, minimally invasive approach to treat BPH called UroLift®.
Instead of removing prostate tissue, this procedure implants a device that pulls the prostate away from the urethra on both sides and holds it in place. This widens the urethra and restores normal urine flow.
Its like opening a curtain, says UH urologist Irina Jaeger, MD.
This procedure is a nice alternative, because the side effects are very minimal, it can be done in the doctors office in 15 minutes or less and very little sedation is required, she says. And the results are pretty instant.
UroLift®has been in use for six years. Studies have shown that the procedure is safe, effectively relieves symptoms and does not affect sexual function.
The only side effects are a little irritation immediately after the procedure. Patients are typically back to their normal routines within a day or two.
For more information about UroLift® and other treatments for BPH, or to schedule a consultation with a mens health expert, call or visit our website.
Diagnosing An Enlarged Prostate
As with all incontinence conditions, a thorough diagnosis must be developed before action can be taken.; You may have heard of some of these exams. And if you havent, now is a good time to familiarize yourself with them. Not only is knowledge power, but it also eliminates surprises.
Because those with BPH can experience symptoms from mild to severe, the treatment options featured here are organized from least invasive to more intense.
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Assessing The Symptoms Of An Enlarged Prostate
To help your doctor understand how bothersome enlarged prostate symptoms are for you, the American Urological Association has developed a BPH Symptom Index. This is a brief questionnaire that asks about specific symptoms and how frequently they occur. Each answer is assigned a number — and your total is ranked on a scale ranging from mild to severe.
A score of 0 to 7 is considered a mild symptom score; 8 or over is considered moderate to severe.
The AUA recommends the following treatment for an enlarged prostate based on the severity of symptoms:
- Mild symptoms that don’t bother you : If you are not bothered by your symptoms, and they don’t affect your daily life, watchful waiting is the best option for you. You should get regular checkups to make sure that you are not developing complications.
- Moderate to severe symptoms : If you are not bothered by your symptoms, you may choose watchful waiting. However, if your symptoms do start to interfere, you may choose medication, a minimally invasive procedure, or surgery.
- Moderate to severe symptoms with complications: If symptoms are bothersome and you have developed complications such as inability to urinate, you may need a catheter, surgery, or other treatment.
How Is Bph Diagnosed
- A urine test may be used to measure the amount of urine left in your bladder after you urinate.
- A digital rectal exam is used to check the size of your prostate. Your healthcare provider will insert a gloved finger into your rectum. The provider will be able to feel your prostate. The exam may be repeated over time to check the prostate size. The size of your prostate may be checked with ultrasound pictures.
- A PSA test is used to measure the amount of a protein made by your prostate gland. A blood sample is taken for this test. A high PSA level can increase your risk for more severe urination problems or the need for surgery.
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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 Treatments Are Available For An Enlarged Prostate
For men diagnosed with benign prostatic hyperplasia , there are various treatment optionsfrom lifestyle changes, medication, to surgery. Men may be overwhelmed by the amount of options available and fearful of potential side effects. Urologist Dr. Stephen Summers explains what treatments are available and which options may work best for you.
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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, it’s 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.
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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Herbal Therapies For An Enlarged Prostate
Several herbal supplements are marketed for enlarged prostates. Saw palmetto, beta-sitosterol, and pygeum are all are widely used in Europe. They are available in the U.S. and don’t require a prescription.
However, researchers and doctors are cautious about advising patients to try herbal supplements. Because they are not FDA-regulated, there are concerns about a product’s quality from batch to batch, according to the NIH’s Office of Dietary Supplements. Also, the safety of an herbal product depends on many things — the chemical makeup, how it works in the body, how it is prepared, and the dosage.
Something else to consider: Like any drug, a herbal remedy can affect how other medications or treatments work, or interact dangerously with your other medications. They can also have side effects. And, the AUA points out, they have not been well-studied for effectiveness or safety.
Before trying any alternative treatment, learn as much as you can about it, the AUA says. Most importantly — talk to your doctor before you try an herbal remedy. Many doctors consider alternative therapies like saw palmetto to “have no effect on symptoms, except as expensive placebos,” Slawin tells WebMD.
Beta-sitosterol: This compound is extracted from pollen of rye grass. There has been some evidence that it provides relief from urinary symptoms. However, in four studies the supplement did not increase urinary flow rates, shrink the prostate, or improve bladder emptying.