What every man should know about an enlarged prostate

What every man should know about an enlarged prostate

When men hear of another man who has an enlarged prostate, their first thoughts are often that it must be prostate cancer.  That is not always true.  An enlarged prostate is more likely due to what is known as benign prostatic hyperplasia (BPH) which is the most common cause of prostate enlargement in men past the age of 50.  BPH becomes more prominent as a man ages since about half of all men between the ages of 51 and 60 will develop it and up to 90% of men over the age of 80 will have it.

If a man lives long enough, there is a very good chance he will develop BPH.  Because it is a common condition as a man ages, all men should be educated about BPH and what the symptoms of it are.  If they begin to notice symptoms, they should have it checked out as soon as possible.

During a man’s lifetime, the prostate has two main growth periods.  The first is when he goes through puberty in which the prostate will double in size.  The second growth period starts around age 25 after which the prostate will begin to grow again.  It is natural for the prostate to grow and this is what is referred to as BPH.  This benign condition does not lead to prostate cancer but the two can coexist.

As the prostate gland enlarges it will squeeze the urethra which runs through the center of the gland and overtime, restricts the flow of urine resulting in symptoms.

There are specific symptoms of BPH a man may experience.  Not all men will have symptoms but if they do, they may include the following:

·      A hesitant, interrupted, weak urine stream

·      Urgency, leaking, or dribbling

·      A sense of incomplete emptying

·      More frequent urination, especially at night

·      Pain or burning with urination

·      Blood in the urine

There are certain risk factors that can increase the likelihood of a man developing BPH.  They include:

·      Age

·      Family history – having a blood relative such as a father or brother with BPH increases the risk

·      Ethnicity – African American men are at the highest risk for BPH with Asian men have the least.

·      Diabetes and heart disease

·      Obesity

It is important for all men over the age of 50 to have their prostate checked annually even if they have no symptoms.  Starting at age 40, all men should have a baseline prostate specific antigen (PSA) test.  A yearly physical exam along with a PSA test and a digital rectal exam can help determine if a man’s prostate is enlarging.

There several treatment methods that can be used to reduce the symptoms a man may be having.  If a man has no symptoms or if they are very mild, treatment may not be required.  Treatment for BPH will depend if the prostate is continuing to enlarge and what symptoms are present.  Options for treating BPH include:

·      Active surveillance or watchful waiting.  This is done if a man has few if any symptoms and the prostate enlargement is stable.

·      Medications used for controlling symptoms such as Avodart, Cardura, Uroxatral, Proscar, Cialis, and Flomax

·      Transurethral resection of the prostate (TURP).  This surgery is considered to be the optimum treatment for BPH.  It reduces symptoms in 80-90% of patients. 

·      Transurethral needle ablation (TUNA).  This procedure involves passing a scope into the urethra placing needles into the prostate gland.  Radio waves pass through the needles heating and destroying excess prostate tissue blocking urine flow.

Men with BPH who have symptoms need to work with their doctor determining which treatment option is right for them.  Every man who comes into my office is treated uniquely as an individual who has their own specific needs.  This is not about a one-size-fits-all approach.  Men deserve the very best in dealing with BPH so they can live their life to the fullest.