The prostate is a gland that produces the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through which urine passes out of the body.
An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems.
An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.
The actual cause of prostate enlargement is unknown. Factors linked to aging and changes in the cells of the testicles may have a role in the growth of the gland. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.
Also, if the testicles are removed after a man develops BPH the prostate begins to shrink in size.
Some facts about prostate enlargement:
The likelihood of developing an enlarged prostate increases with age.
BPH is so common that it has been said all men will have an enlarged prostate if they live long enough.
A small amount of prostate enlargement is present in many men over age 40. More than 90% of men over age 80 have the condition.
No risk factors have been identified other than having normally functioning testicles.
Less than half of all men with BPH have symptoms of the disease. Symptoms may include:
Reduce stress. Nervousness and tension can lead to more frequent urination.
Alpha 1-blockers are a class of drugs that are also used to treat high blood pressure. These medicines relax the muscles of the bladder neck and prostate. This allows easier urination. Most people who take alpha 1-blockers notice improvement in their symptoms. .
Finasteride and dutasteride lower levels of hormones produced by the prostate. These drugs also reduce the size of the gland, increase urine flow rate, and decrease symptoms of BPH. You may need to take these medicines for 3 to 6 months before you notice symptoms getting better. Possible side effects include decreased sex drive and impotence.
Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may occur with BPH. BPH symptoms improve in some men after a course of antibiotics.
Many herbs have been tried for treating an enlarged prostate. Many men use saw palmetto to ease symptoms. Some studies have shown that it may help with symptoms, but results are mixed and more research is needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.
The choice of a specific surgical procedure is usually based on the severity of your symptoms and the size and shape of your prostate gland.
Transurethral resection of the prostate(TURP): This is the most common and most proven surgical treatment for BPH. TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.
Simple prostatectomy: An open prostatectomy is usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineum (the area behind the scrotum). Only the inner part of the prostate gland is removed. The outer portion is left behind. This is a long procedure. Most people need to stay in the hospital for 5 to 10 days. This treatment is most often done on men who have very large prostate glands.
Most men who have prostate surgery have improvement in urine flow rates and symptoms.
Other, less-invasive procedures use heat to destroy prostate tissue. None have been proven to be better than TURP. Patients who receive these procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:
Younger men (many of the less-invasive procedures carry a lower risk for impotence and incontinence than TURP, although the risk with TURP is not very high)
Patients with severe medical conditions, including uncontrolled diabetes, cirrhosis, alcoholism, psychosis, and serious lung, kidney, or heart disease