The prostate is a small gland in the male reproductive system that produces part of the fluid that carries sperm. The gland tends to grow slowly throughout adulthood, so men may develop benign prostatic hyperplasia (BPH), commonly called an enlarged prostate. This condition becomes more common with age, particularly after 50. The prostate surrounds part of the tube that carries urine out of the body, so its growth can affect urinary function.
What Is an Enlarged Prostate?
The prostate sits directly beneath the bladder. With age, changes in hormone levels may cause the gland to enlarge. When this growth is noncancerous, it is classified as BPH. BPH and prostate cancer are separate conditions, but both can be present at the same time. Advancing age is the factor most commonly associated with an enlarged prostate. A family history of prostate conditions also raises the likelihood, as may diabetes and heart disease. Not every man with an enlarged prostate notices symptoms; the size of the gland also does not always correspond to how severe those symptoms are.
How Is It Detected?
As the prostate grows, it may press against the urethra and bladder. This can disrupt the normal flow of urine. An enlarged prostate may be associated with urinary tract infections or bladder stones, and a sudden inability to urinate requires prompt medical attention. Other commonly reported symptoms include:
- Frequent urination, particularly at night
- Sudden, strong urge to urinate
- Weak or interrupted stream
Diagnosis generally begins with a review of medical history, current medications, and symptoms. A physical examination can include a digital rectal exam, which allows the provider to estimate the size of the prostate. Further testing may follow. A urinalysis can detect signs of infection, and a prostate-specific antigen (PSA) blood test measures a protein produced by the prostate. Urine flow tests record the strength and volume of urination. A post-void residual test measures how much urine remains in the bladder afterward. These assessments help a urologist distinguish an enlarged prostate from other conditions with similar symptoms.
How Is One Managed?
Treatment plans vary from case to case, and they can be personalized according to symptom severity, prostate size, and an individual’s overall health. For men with mild symptoms, a urologist may recommend monitoring for changing or worsening symptoms rather than immediate treatment. Lifestyle adjustments can include limiting fluids in the evening and reviewing current medications that affect urination.
When symptoms are more bothersome, medication is a common next step. Alpha-blockers relax the muscles of the prostate and bladder neck, and this can improve urine flow. 5-alpha reductase inhibitors act on hormones associated with prostate growth and may gradually reduce gland size. Some patients receive a combination of both.
If medication does not provide adequate relief, targeted procedures may be explored. Surgical options include laser and microwave procedures, and these aim to remove or reduce obstructing tissue. Each approach differs in suitability for a given patient.
Confer With a Urologist
BPH is a long-term condition, and symptoms can shift gradually over the years. Periodic follow-up visits allow a urologist to track these changes, adjust medications, and determine whether a different approach may be appropriate. If you notice changes in your urinary habits, a urologist can evaluate your symptoms and outline treatment options suited to your needs.
