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Home Treatments Prostate Enlargement (Benign Prostatic Hyperplasia)

Prostate Enlargement (Benign Prostatic Hyperplasia)

Benign prostatic hyperplasia (BPH), also known as prostate enlargement, is a common condition that affects many men as they age. At SCI Hospital, our experienced urologists are dedicated to helping you understand and manage this condition, They will explore the causes, symptoms, diagnosis, and treatment options for BPH, providing you with a comprehensive understanding of this condition.

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What is prostate enlargement? What are the main causes of prostate enlargement What are the symptoms for prostate problems? What are the complications of benign prostatic hyperplasia? How to prevent enlarged prostate? How is benign prostatic hyperplasia diagnosed? Treatment for Prostate Enlargement (Benign Prostatic Hyperplasia) Outlook / Prognosis

What is prostate enlargement?

Prostate enlargement, or benign prostatic hyperplasia (BPH), is a common condition that affects many men as they age. The prostate gland is a small, walnut-sized gland located below the bladder that surrounds the urethra, the tube that carries urine out of the body. As men age, the prostate gland can grow larger, which can lead to a range of urinary symptoms. At SCI Hospital, our experienced urologists are dedicated to helping you understand and manage this condition.

What are the main causes of prostate enlargement

Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition that affects many men as they age. While the exact cause is still not fully understood, several factors are believed to contribute to its development. [1]

  • Age: As men get older, the risk of developing BPH increases, with most cases occurring after age 50. In fact, it's rare for men under 40 to experience BPH.
  • Hormonal Changes: As men age, there's a shift in the balance of testosterone and estrogen. This can lead to an increase in estrogen levels within the prostate, which may promote prostate cell growth. [8]
  • Genetics: Having a family history of prostate problems can increase the likelihood of developing BPH.
  • Lifestyle Factors: Obesity has been linked to an increased risk of BPH.
  • Medical Conditions: Diabetes and heart disease may also increase the risk of BPH.

What are the symptoms for prostate problems?

The symptoms of enlarged prostate can vary in severity, but common signs include: [1]

  • Frequent Urination: Needing to urinate more often, especially at night.
  • Difficulty Starting Urination: Struggling to start urinating.
  • Weak Urine Stream: A weak or interrupted urine stream.
  • Dribbling: Dribbling at the end of urination.
  • Feeling of Incomplete Bladder Emptying: Feeling like the bladder is not completely empty.
  • Sudden Urges to Urinate: Sudden and intense urges to urinate.
  • Straining to Urinate: Straining to urinate.
  • Increased Urgency: Feeling a strong need to urinate.
  • Incontinence: Leaking urine.
  • Pain: Pain when urinating or after ejaculation.
  • Blood in the Urine: Rarely, blood may be present in the urine.

What are the complications of benign prostatic hyperplasia?

If left untreated, BPH can lead to several complications:

  • Urinary tract infections (UTIs): The enlarged prostate can block urine flow, causing urine retention in the bladder. This stagnant urine becomes a breeding ground for bacteria, leading to frequent UTIs. [2]
  • Bladder stones: Incomplete bladder emptying can result in concentrated urine, promoting the formation of bladder stones.
  • Bladder damage: Chronic urine retention can stretch and weaken the bladder muscles over time, potentially leading to a condition called decompensated bladder.
  • Kidney damage: Prolonged pressure in the bladder from urine retention can damage the kidneys or allow bladder infections to spread to the kidneys. [7]
  • Urinary retention: In severe cases, BPH can lead to complete inability to urinate, which is a medical emergency requiring immediate intervention.
  • Overactive bladder: The enlarged prostate pressing on the bladder can cause increased sensitivity and involuntary contractions, leading to frequent and urgent urination.
  • Kidney stones: Similar to bladder stones, the concentrated urine resulting from incomplete bladder emptying can promote kidney stone formation.
  • Hematuria (blood in urine): The enlarged prostate's increased vascularity can lead to bleeding, resulting in blood in the urine.
  • Recurrent infections: The inability to fully empty the bladder can lead to recurring UTIs and other infections.
  • Detrusor hypotonicity: The bladder muscles may become weak and lose their ability to contract effectively. [2]
  • Incontinence: Paradoxically, severe BPH can sometimes lead to urinary incontinence due to overflow or bladder instability.

How to prevent enlarged prostate?

While it's not always possible to prevent BPH, some lifestyle changes may help reduce your risk or manage symptoms:

  • Maintain a healthy weight: Obesity has been linked to an increased risk of BPH. Keeping your weight in check through a balanced diet and regular exercise can help reduce the likelihood of developing prostate problems. [3]
  • Exercise regularly: Engaging in physical activity, particularly aerobic exercises and strength training, can help improve overall health and potentially reduce BPH symptoms. Aim for at least 150 minutes of moderate-intensity exercise per week.
  • Eat a balanced diet rich in fruits and vegetables: A diet high in fruits, vegetables, and whole grains may help reduce the risk of BPH. Some studies suggest that foods rich in antioxidants, such as tomatoes and berries, may be particularly beneficial for prostate health.
  • Limit caffeine and alcohol intake: Both caffeine and alcohol can irritate the bladder and increase urinary frequency. Reducing consumption, especially in the evening, may help alleviate BPH symptoms.
  • Practice pelvic floor exercises: Also known as Kegel exercises, these can help strengthen the muscles that control urination. Strong pelvic floor muscles may help improve bladder control and reduce some BPH symptoms.
  • Manage stress: Chronic stress can exacerbate urinary symptoms. Implementing stress-reduction techniques such as meditation, deep breathing exercises, or yoga may help manage BPH symptoms. [7]
  • Stay hydrated, but time your fluid intake: While it's important to stay hydrated, try to limit fluid intake in the evening to reduce nighttime urination.
  • Avoid certain medications: Some over-the-counter cold and allergy medications can worsen BPH symptoms. Always consult with your healthcare provider about potential drug interactions.
  • Quit smoking: Smoking has been linked to an increased risk of BPH progression. Quitting can improve overall health and potentially slow the progression of prostate enlargement. [8]
  • Consider herbal supplements: Some men find relief with herbal remedies like saw palmetto, though scientific evidence is mixed. Always consult with a healthcare provider before starting any supplement regimen.

How is benign prostatic hyperplasia diagnosed?

To diagnose BPH, your doctor may perform several tests:

Digital rectal exam (DRE)

A digital rectal exam is often the first test performed to evaluate the prostate. During this exam:

[3]
  • The doctor inserts a gloved, lubricated finger into the rectum to feel the prostate gland.
  • They assess the size, shape, and consistency of the prostate.
  • This exam can help detect prostate enlargement and identify any abnormal areas.

    • Prostate-specific antigen (PSA) blood test

    The PSA blood test measures the level of prostate-specific antigen in your blood. While primarily used to screen for prostate cancer, it can also provide information about BPH: [3]

    • Elevated PSA levels may indicate an enlarged prostate.
    • However, PSA levels can be affected by various factors, so this test is usually considered alongside other diagnostic tools.

    Urinalysis

    A urinalysis involves examining a urine sample to:

    • Check for signs of infection [3]
    • Look for blood in the urine
    • Assess other urinary tract issues that may be causing symptoms

    Uroflowmetry

    Uroflowmetry is a non-invasive test that measures urine flow. During this test:

      You urinate into a special device that measures the speed and volume of urine flow.
    • Reduced flow rates may indicate obstruction due to an enlarged prostate.

    Postvoid residual volume test

    This test checks for remaining urine in the bladder after urination:

    • It's typically done using ultrasound or catheterization.
    • A large amount of residual urine may indicate that the bladder is not emptying properly due to BPH. [4]

    Prostate ultrasound

    A prostate ultrasound, also known as transrectal ultrasound (TRUS), provides detailed images of the prostate:

    • It can accurately measure the size and shape of the prostate.
    • This test may be used to guide prostate biopsies if cancer is suspected.

    Cystoscopy

    Cystoscopy is a procedure that allows the doctor to visually examine the inside of the urethra and bladder:

    • A thin, flexible tube with a camera (cystoscope) is inserted through the urethra.
    • This test can help identify blockages, bladder stones, or other issues related to BPH.
    • Cystoscopy is typically reserved for cases where other tests are inconclusive or additional information is needed. [4]

      • Your doctor may not perform all of these tests. The choice of diagnostic tools depends on your symptoms, medical history, and initial examination findings. These tests help create a comprehensive picture of your prostate health and urinary function, allowing for an accurate diagnosis and appropriate treatment plan.

Treatment for Prostate Enlargement (Benign Prostatic Hyperplasia)

Treatment options for BPH vary depending on the severity of symptoms and may include watchful waiting, medications, minimally invasive procedures, and surgery. The choice of treatment is typically based on the individual patient's symptoms, prostate size, overall health, and personal preferences.

Watchful waiting

For male individuals with mild symptoms that are not particularly bothersome, watchful waiting may be recommended. This approach involves:

  • Regular check-ups (usually annual) to monitor symptom progression
  • Avoiding medications that can worsen symptoms, such as decongestants and antihistamines
  • Lifestyle modifications, such as limiting fluid intake before bedtime

Medications

Several types of medications can help manage BPH symptoms: [6]

Alpha-blockers: These medications relax the muscles in the prostate and bladder neck, improving urine flow. Examples include:

  • Tamsulosin
  • Alfuzosin
  • Doxazosin
  • Silodosin
  • Terazosin

5-alpha reductase inhibitors: These drugs shrink the prostate by preventing hormone changes that cause prostate growth. Examples include:

  • Finasteride
  • Dutasteride

Combination therapy: Some patients may benefit from a combination of an alpha-blocker and a 5-alpha reductase inhibitor.

Phosphodiesterase-5 inhibitors: Tadalafil may be prescribed to improve BPH symptoms by relaxing smooth muscles in the lower urinary tract.

Minimally invasive procedures

For moderate to severe symptoms, several minimally invasive treatments are available:

  • Transurethral needle ablation (TUNA): Uses radio waves to destroy excess prostate tissue. [5]
  • Transurethral microwave therapy (TUMT): Employs microwave energy to eliminate excess prostate tissue.
  • Prostatic urethral lift (UroLift): Involves placing small implants to lift and hold the enlarged prostate tissue, reducing pressure on the urethra.
  • Water vapor thermal therapy (Rezūm): Uses water vapor to destroy excess prostate tissue.
  • Transurethral incision of the prostate (TUIP): Involves making small cuts in the prostate to reduce pressure on the urethra.

Surgery

In severe cases or when other treatments are ineffective, surgical options may be considered:

  • Transurethral resection of the prostate (TURP): The most common surgical procedure for BPH, involving removal of the inner portion of the prostate.
  • Laser therapy: Includes techniques such as holmium laser enucleation of the prostate (HoLEP) and photo-selective vaporization of the prostate (PVP). [4]
  • Open prostatectomy: Rarely needed, this procedure is typically reserved for men with very large prostates or other complicating factors.

    • It's important to note that the choice of treatment should be made in consultation with a urologist, taking into account the individual patient's symptoms, overall health, and preferences. Each treatment option has its own set of potential benefits and risks, which should be carefully considered before making a decision.

Dr. Vishal Dutt Gour

MBBS, MS - General Surgery, MCh - Urology/Genito-Urinary Surgery, Urologist, Urological Surgeon, Andrologist

  • Urologist, Urological Surgeon, Andrologist
  • 20+ Years Experience
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Outlook / Prognosis

With proper management and treatment, most men with BPH can experience significant improvement in their symptoms and quality of life. Regular check-ups with your healthcare provider are essential to monitor your condition and adjust treatment as needed.

FAQs

Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland that can cause urinary symptoms in men. It's a common condition that often occurs as men age.

Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland that can cause urinary symptoms in men. It's a common condition that often occurs as men age. If you're experiencing symptoms of BPH, don't hesitate to seek medical attention from a trusted healthcare provider at SCI Hospital. Our skilled and experienced doctors are dedicated to providing you with the best possible care for your condition.

Early signs may include frequent urination (especially at night), difficulty starting urination, a weak urine stream, and feeling that the bladder isn't completely empty after urinating. If you're experiencing any of these symptoms, schedule an appointment with one of our trusted doctors at SCI Hospital to discuss your options for treatment.

As the prostate enlarges, it can compress the urethra (the tube that carries urine out of the body). This can lead to various urinary symptoms and potential complications if left untreated. At SCI Hospital, our doctors are committed to helping you manage your symptoms effectively and develop a personalized treatment plan that addresses your specific needs.

BPH itself doesn't directly cause sexual dysfunction. However, some treatments for BPH may affect sexual function. It's important to discuss any concerns with your doctor. Our doctors at SCI Hospital are dedicated to helping you maintain a healthy sex life while also addressing your BPH symptoms

BPH is very common, especially in older men. It affects about 50% of men by age 60 and up to 90% of men by age 85. At SCI Hospital, we understand the impact that BPH can have on your daily life and are committed to providing you with the best possible care.

While there's no cure for BPH, various treatments can effectively manage symptoms and improve quality of life. These include medications, minimally invasive procedures, and surgery in severe cases. Our skilled and experienced doctors at SCI Hospital are equipped to perform these procedures and will work with you to determine the best course of treatment for your specific needs.

The exact reason is unknown, but age-related hormonal changes and genetics are believed to play a role in prostate enlargement. As men age, the balance of hormones in their body changes, which can lead to prostate growth. At SCI Hospital, our team of urologists is dedicated to helping you understand the causes of your BPH and developing a treatment plan that addresses your specific needs. By understanding the causes, symptoms, and treatment options for benign prostatic hyperplasia, you can work with our trusted doctors at SCI Hospital to manage this common condition effectively and maintain a good quality of life.

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Written By: Dr. Gautam Banga
Education: MBBS, Master of Surgery (MS), M.Ch. Fellowship in Reconstructive Urology. Urologist, Andrologist, Urological Surgeon
Experience: 15 Years
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