Enlarged prostate, is also medically called benign prostatic hyperplasia (BPH). The prostate is a gland that surrounds the urethra (the tube that carries urine from the bladder out through the penis) just below the urinary bladder, and hence when this prostate enlarges, it potentially slows or blocks the urine stream.
This prostate gland is found only in men, and often gets bigger as they get older. Worldwide, the prevalence of diagnosed BPH increases from 8% in men aged 31 to 40 years, to 40 - 50% in men aged 51 to 60 years, to over 80% in men older than 80 years of age.
It is not well known why some men develop symptoms of BPH or lower urinary tract symptoms and others do not, but research has shown strong evidence that certain hormones such as testosterone are strongly involved in development of BPH,although these hormones alone do not cause the condition. The prostate normally enlarges to some degree in all men with advancing age, although not all men require treatment.
The symptoms of BPH usually begin after age 50 years. The most common symptoms of BPH include; frequent urination especially at night, a hesitant and interrupted or weak stream of urine, the need to urinate frequently, leaking or dribbling of urine
These symptoms tend to appear over time and may gradually worsen over the years. However, some men have an enlarged prostate that causes few or no symptoms, while other men have symptoms of BPH that later improve or stay the same. Some men are not bothered by their symptoms, while others are bothered a lot.
In a small percentage of men, untreated BPH can cause urinary retention (meaning that the man is unable to empty the bladder) which can present with severe acute pain necessitating immediate medical attention to relieve the retention, and the risk of developing urinary retention increases with age and as symptoms worsen.
Men with recurrent urinary tract infections are more likely to have an enlarged prostate because of poor bladder emptying which provides ground for bacteria in urine to multiply significantly and cause urinary tract infection symptoms.
It is important to know that symptoms of BPH can also be caused by other conditions, such as prostate or bladder cancer, kidney stones, urethral stricture, overactive bladder, etc.
The diagnosis of benign prostate hypertrophy is made by taking proper history of the patient’s symptoms, physical examination and investigations done to confirm the diagnosis and rule out other causes of same symptoms such as prostate cancer. A rectal examination is performed to feel the size and shape of the prostate gland and this can help to determine if there are signs suspicious of prostate cancer. A sample of urine may be taken off to look for any features of urinary tract infection. Blood laboratory tests for the likelihood of prostate cancer are usually done
Other medical investigations maybe carried out to rule out possible complications
Having BPH (enlarged prostate) does not increase ones risk for prostate cancer. However, it is possible to have both BPH and prostate cancer at the same time. If the doctor is not convinced if one’s condition is due to either BPH or Prostate cancer based on either history, examination or blood investigations, further testing will be done to be sure that one doesn’t have prostate cancer
Treatment will depend on ones symptoms and severity of the condition. For mild conditions, the doctor might decide to wait and observe the symptoms overtime before any treatment is given since some forms of BPH symptoms improve overtime without treatment.
If the symptoms are bothersome or persistent, the doctor might decide to prescribe some medicines to help with the condition. There are two main types of medicines used to manage BPH. One type relaxes the muscles that surround the urethra. The other type keeps the prostate from growing more or even helps the prostate shrink. In some cases, the doctor might prescribe both types of medicine at the same time.
If medicines do not relieve the BPH symptoms, a surgical treatment may be recommended. Surgery is used to reduce to reduce the amount of prostate tissue around the urethra. This may be done by either removing some prostate tissue or shrinking the prostate.
Once diagnosed with an enlarged prostate, there are some lifestyle modification changes that can help reduce the symptoms and these can include; reducing the amount of fluid you drink especially just before bed, limiting the amount of alcohol and caffeine you drink (These drinks can make you urinate more often), avoiding some cold/flu and allergy medicines that contain antihistamines or decongestants (These medicines can make the symptoms of BPH worse), doing something medically called “double voiding”( That means that after they empty their bladder, they wait a moment, relax, and try to urinate again).