What is Enlarged Prostate? Know what are the causes, symptoms & treatment of it?

The prostate refers to a muscular, small and walnut-shaped gland in the male reproductive gland. It surrounds the urethra and makes the fluid in semen. This Prostate fluid is vital for a man’s fertility. 

Its muscular action helps to push the fluid and semen via your penis during intercourse. 

However, in many men with age this prostate can become enlarged and can lead to several complications. 

An enlarged prostate occurs in almost all men as they grow older. 

However, the good part is that there are treatments available. 

Read on to understand various causes, symptoms, treatments, and other aspects behind enlarged prostate.

 

Benign Prostatic Hyperplasia

Enlargement of the prostate is known as Benign Prostatic Hyperplasia (BPH) in medical terms. It happens when the cells of the prostate gland start to increase. These extra cells can swell your prostate gland. This, in turn, squeezes the urethra and decreases the urine flow. 

As the man grows older, the prostate goes through two main growth periods. The first one happens early in puberty. Here the prostate doubles in size. 

The second growth takes place around the age of 25 and lasts during most of a man’s lifetime. Benign prostatic hyperplasia mostly follows with the second growth stage.

When the prostate enlarges, the gland thrust against and tweaks the urethra. The bladder wall, in turn, develops thicker. 

Ultimately, the bladder weakens and lose the capability to empty fully, leaving some urine in the bladder. The contraction of the urethra, urinary retention, and the failure to empty the bladder lead to various concerns related to benign prostatic hyperplasia.

Causes of BPH

The actual causes of BPH are presently unknown. It occurs generally in older men. 

Benign prostatic hyperplasia does not occur in men who have got their testicles removed before attaining puberty. 

Due to this reason, some scientists believe that factors linked to ageing and the testicles may cause Benign prostatic hyperplasia. 

As men grow old, the quantity of active testosterone in their blood decreases. This leaves a higher proportion of estrogen. 

Various researches have submitted that BPH may happen because the higher proportion of estrogen in the prostate gives a boost to the activity of substances that promote prostate cell growth.

Another concept emphasis on dihydrotestosterone (DHT), a male hormone that assists in prostate development and growth.

 

Symptoms 

Enlarged prostate showcase some or all of the symptoms below:

1. A sense of partial bladder emptying
2. A fragile or slow urinary stream
3. A urinary stream that either starts and stops
4. Straining to urinate
5. Nonstop dribbling of urine
6. Difficulty in urinating
7. Regular urination
8. Urgency to urinate
9. Getting up often at night to urinate
10. Recurring to urinate again minutes after finishing

 

One could risk creating urinary tract infections if the bladder does not empty completely. 

Other serious concerns can also arise with time. This includes bladder stones, blood in the urine, incontinence, and acute urinary retention. 

Abrupt and thorough incompetence to urinate is a medical emergency. Hence, one must consult his health expert immediately. In rare cases, bladder and/or kidney damage can also develop from BPH.

Diagnosis 

The health expert will question you about your symptoms and then conduct a physical exam. This initial exam is likely to include:

1. Blood test: The results can indicate kidney problems.

2. Prostate-specific antigen (PSA) blood test: It is a substance produced in your prostate. Its levels increase when you have BPH. However, high PSA levels can also be due to fresh procedures, infection, surgery or prostate cancer.

3. Urine test: Examining your urine sample can assist doctors to rule out an infection or other complications that can cause similar symptoms.

Then, the doctor may advise for additional tests to confirm the existence of enlarged prostate. Such tests include: 

1. Urinary flow test: You will be asked to urinate into a container attached to a machine. This is to measure the strength and amount of your urine flow. Test results help decide whether your condition is getting better or worse.

2. 24-hour voiding diary: In this test, the frequency and amount of urine are recorded. It is especially helpful if more than one-third of your daily urinary output happens at night.

4. Postvoid residual volume test: This test is performed to analyse whether you can empty your bladder completely. The test can be done using ultrasound or by inserting a catheter into your bladder after you urinate.  

Treatments 

The treatment solutions for Benign Prostatic Hyperplasia are categorized into:

1. Lifestyle changes
2. Medications
3. Minimally invasive procedures
4. Surgery

Let’s discuss them one by one in detail.

1. Lifestyle changes: These are the recommended lifestyle changes for men whose symptoms are mild or slightly bothersome.

i.  Decreasing intake of liquids, specifically before going out in public or before periods of sleep

ii. Avoiding or reducing the consumption of caffeinated beverages and alcohol

iii. Monitoring the use of medicines such as antihistamines, decongestants, antidepressants, etc.

iv.Exercising pelvic floor muscles

v. Avoiding/treating constipation

2. Medications: An urologist (a doctor who specializes in the treatment of disorders of the urinary system) may recommend medications that either stop the growth of or shrink the prostate. 

i. Alpha-blockers

ii. Combination medications

iii. 5-alpha reductase inhibitors

iv. Phosphodiesterase-5 inhibitors

3. Minimally Invasive Procedures: These procedures are meant to relieve benign prostatic hyperplasia symptoms when medications prove unsuccessful. 

i. Transurethral needle ablation

ii. Prostatic stent insertion

iii. High-intensity focused ultrasound

iv. Transurethral electro vaporization

v. Transurethral microwave thermotherapy

vi. Water-induced thermotherapy

4. urgery: Surgery to remove enlarged prostate tissue includes: 

i. Transurethral resection of the prostate (TURP)

ii. Laser surgery

iii. Transurethral incision of the prostate (TUIP)

iv. Open prostatectomy

 

Final words

BPH doesn’t always require medical treatment. Your health expert may require you to have consistent check-ups to evaluate your symptoms and the size of your prostate.

It’s significant to discuss your BPH symptoms with your doctor, no matter how negligible you feel they may be.

At Neotia Getwel Healthcare Centre, our healthcare providers will work with you to create a treatment plan that helps you control your symptoms and live a productive life. Book your appointment here.