An enlarged prostate is a common health problem in older men. Although benign prostatic hyperplasia does not mean that a man has prostate cancer, it can cause uncomfortable urinary symptoms and, when left untreated, may sometimes lead to complications.
Introduction
As men grow older, changes in the prostate gland become increasingly common. One of the most common changes is benign prostatic hyperplasia (BPH), also known as an enlarged prostate.
The prostate is a small gland located below the bladder and surrounding part of the urethra, the tube that carries urine out of the body. As the prostate grows, it can press against the urethra and interfere with the normal flow of urine.
BPH is not prostate cancer, and having BPH does not mean that a man will develop prostate cancer. However, the symptoms can significantly affect sleep, daily activities, work, travel, and quality of life.
What Is an Enlarged Prostate?
BPH is a non-cancerous enlargement of the prostate that becomes more common with age.
The prostate naturally grows throughout a man’s life. For some men, this growth eventually becomes large enough to interfere with urination.
The severity of symptoms does not always correspond to the size of the prostate. A relatively small enlargement can cause significant urinary problems in some men, while another man with a larger prostate may experience few symptoms.
What Causes BPH?
The exact reason some men’s prostates enlarge more than others is not completely understood. However, ageing and changes in male hormones appear to contribute to prostate growth.
BPH becomes increasingly common as men get older. A family history of prostate problems may also increase the likelihood of developing the condition.
Other factors, including obesity, diabetes, heart disease, and a lack of physical activity, have also been associated with an increased risk of BPH.
8 Common Symptoms of an Enlarged Prostate
BPH mainly affects urination, and the symptoms may develop gradually.
1. Frequent Urination
A man may feel the need to urinate more often than usual, particularly during the night.
2. Getting Up Frequently at Night
Waking several times during the night to urinate is known as nocturia. It can interfere with sleep and leave a person tired during the day.
3. Difficulty Starting Urination
Some men experience a delay before urine begins to flow, even when they feel that their bladder is full.
4. Weak Urine Stream
The urine stream may become weaker or slower than it used to be.
5. Urine Dribbling
A small amount of urine may continue to leak or dribble after urination appears to have finished.
6. Feeling That the Bladder Has Not Emptied
A man may still feel that he needs to urinate even immediately after using the toilet.
7. Urgency to Urinate
There may be a sudden and difficult-to-control urge to urinate.
8. Interrupted Urine Flow
The urine stream may stop and start during urination.
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Is BPH the Same as Prostate Cancer?
No. BPH and prostate cancer are two different conditions.
BPH is benign, meaning non-cancerous, enlargement of the prostate. Prostate cancer occurs when abnormal prostate cells grow uncontrollably.
However, some urinary symptoms can occur with several prostate or urinary conditions. This means that a man should not assume that urinary problems are simply caused by an enlarged prostate.
A healthcare professional can determine the likely cause through an appropriate evaluation.
How Is BPH Diagnosed?
The evaluation may begin with questions about urinary symptoms, medical history, medications, and how frequently symptoms occur.
A doctor may also perform a physical examination and, when appropriate, a digital rectal examination to assess the prostate.
Other tests may include a urine test, blood tests, measurement of urine flow, assessment of how much urine remains in the bladder after urination, or imaging of the urinary tract.
A prostate-specific antigen (PSA) blood test may also be considered in appropriate men. PSA can be elevated for several reasons, including BPH, prostatitis, and prostate cancer, so it cannot by itself diagnose prostate cancer.
Treatment for an Enlarged Prostate
Not every man with BPH needs immediate treatment. Men with mild symptoms may be monitored while making lifestyle changes.
When symptoms become bothersome, medications or procedures may be considered.
Lifestyle Changes
Men with mild urinary symptoms may benefit from simple changes such as reducing fluids before bedtime, limiting caffeine and alcohol, avoiding medications that worsen urinary symptoms when medically appropriate, and making regular bathroom visits rather than waiting until the bladder is extremely full.
Physical activity and maintaining a healthy weight can also support overall urinary and cardiovascular health.
Medicines
Several types of medicines are used to manage BPH.
Alpha blockers relax muscles around the prostate and bladder neck, making it easier for urine to flow.
5-alpha reductase inhibitors can gradually reduce prostate size and lower the risk of urinary retention in men with appropriately enlarged prostates.
Some men may receive a combination of these medicines when one medication alone does not adequately control symptoms.
Other medications may be used for specific urinary symptoms, depending on the individual’s situation.
Treatment should be prescribed by a healthcare professional because these medicines can have side effects and may interact with other medications.
Minimally Invasive Procedures
When medication does not provide enough relief or causes unwanted side effects, minimally invasive procedures may be considered.
These treatments use different techniques to reduce or remove prostate tissue that is blocking urine flow. The appropriate option depends on prostate size, symptoms, overall health, and available expertise.
Surgery
For men with severe symptoms or complications, surgery may be recommended.
One established surgical treatment is transurethral resection of the prostate (TURP), which removes prostate tissue that is blocking urine flow.
Other surgical techniques are also available, and a urologist can explain which approach is most appropriate.
Can BPH Cause Complications?
Possible complications include urinary retention, recurrent urinary tract infections, bladder stones, bladder damage, and kidney problems.
Sudden inability to urinate is particularly important. Acute urinary retention is a medical emergency and requires prompt medical attention.
When Should a Man See a Doctor?
A man should speak with a healthcare professional if he develops persistent difficulty urinating, a weak urine stream, frequent nighttime urination, urinary urgency, blood in the urine, painful urination, or a feeling that the bladder does not empty completely.
Men should seek urgent medical attention if they suddenly become unable to pass urine, develop severe lower abdominal pain, or experience other serious symptoms.
Can BPH Be Prevented?
Maintaining a healthy weight, exercising regularly, eating a balanced diet rich in vegetables and whole foods, limiting excessive alcohol, and managing conditions such as diabetes and high blood pressure can contribute to better overall health.
Men should also discuss urinary symptoms with their healthcare professionals rather than attempting to treat persistent symptoms with unproven supplements or medications.
Final Thoughts
An enlarged prostate is a common condition among aging men, but urinary symptoms should not simply be accepted as an unavoidable part of getting older.
BPH is not prostate cancer, but it can cause significant urinary problems and, in some cases, complications. The good news is that several effective treatment options are available, ranging from lifestyle changes and medications to minimally invasive procedures and surgery.
If you notice changes in your urinary habits, especially if the symptoms are persistent or getting worse, speak with a healthcare professional.