The prostate is a walnut-sized organ that surrounds the lower part of a man’s bladder in front of the rectum. The prostate makes the fluids in semen that feed and transport sperm. As men age, it is common for the prostate to enlarge.
WHAT ARE THE SYMPTOMS?
The common symptoms of an enlarged prostate include:
- Difficulty urinating or a weak urinary stream;
- Stopping and starting during urination or significant dribbling after urination;
- Incomplete emptying of the bladder;
- Having to urinate again shortly after urination;
- Frequent urination, especially at night;
- Urgent need to urinate; and
- Blood in the urine.
CAUSES AND RISK FACTORS
It isn’t known what causes prostate enlargement. Risk factors include:
- Age;
- Race;
- Family history; and
- Marital status (married men have higher rates of enlarged prostate than unmarried men).
DIAGNOSIS
Physicians typically use a quick test to diagnose and assess the severity of an enlarged prostate. The test, known as the International Prostate Symptom Score, asks the patient to assess the frequency of urinary symptoms in the past month. A urine flow study, which measures the strength of the urinary stream, may also be ordered.
Physicians will also perform a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test to screen for prostate cancer. While PSA is not used to diagnose enlarged prostate, its level in the blood is moderately elevated in 30 to 50 percent of men who have the condition.
TREATMENT APPROACH
Treatment for enlarged prostate depends on the severity of symptoms.
If symptoms are mild, many physicians recommend watchful waiting, which means scheduling regular examinations to evaluate the prostate rather than actually treating it.
Moderate symptoms usually require drug treatment. Alpha blockers relax the muscles around the urethra, allowing full urine flow. Finasteride (Proscar) can reduce the size of the prostate.
Moderate to severe symptoms may prompt surgery, such as the following options:
- Transurethral resection of the prostate, or TURP;
- Transurethral incision of the prostate, or TUIP;
- Open prostatectomy;
- Laser surgery;
- Transurethral microwave therapy (TUMT);
- Transurethral needle ablation, or TUNA;
- Interstitial laser thermotherapy (Indigo Laser); and
- Water-induced thermal therapy.
LIFESTYLE
Adopting certain habits can reduce the symptoms of enlarged prostate. Physicians may recommend limiting the consumption of beverages in the evening; reducing the consumption of alcohol, which stimulates urination and irritates the bladder; and exercising regularly.
