Prostate gland enlargement
Prostate gland enlargement
Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH) and prostatic hypertrophy, prostate gland enlargement can cause bothersome urinary symptoms. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems.
There are several effective treatments for prostate gland enlargement. In deciding the best option for you, you and your doctor will consider your particular symptoms, the size of your prostate, other health problems you may have and your preferences. Your choices may also depend on what treatments are available in your area. Treatments for prostate gland enlargement include medications, lifestyle changes and surgery.
Prostate gland enlargement varies in severity among men and tends to gradually worsen over time. Prostate gland enlargement symptoms include:
The size of your prostate doesn't necessarily mean your symptoms will be worse. Some men with only slightly enlarged prostates have significant symptoms. On the other hand, some men with very enlarged prostates have only minor urinary symptoms.
Only about half the men with prostate gland enlargement have symptoms that become noticeable or bothersome enough for them to seek medical treatment. In some men, symptoms eventually stabilize and may even improve over time.
When to see a doctor
If you don't find urinary symptoms too bothersome and they don't pose a health threat, you may not need treatment. But you should still have your symptoms checked out by a doctor to make sure they aren't caused by another problem such as prostate cancer.
The prostate gland is the male organ that produces most of the fluid in semen, the milky-colored fluid that nourishes and transports sperm out of the penis during ejaculation (orgasm). It sits beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. So, when the prostate enlarges, it begins to block (obstruct) urine flow.
Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow. Doctors aren't sure exactly what causes the prostate to enlarge. It may be due to changes in the balance of sex hormones as men grow older.
Comparing normal and enlarged prostate glands
At normal size, the prostate gland is about the size and shape of a walnut or golf ball. When enlarged, the prostate may obstruct urine flow from the bladder and out the urethra. ...
The main risk factors for prostate gland enlargement include:
Prostate gland enlargement becomes a serious problem when it severely interferes with your ability to empty your bladder. If this is the case, you'll probably need surgery. Complications of enlarged prostate include:
Most men with an enlarged prostate don't develop these complications. However, acute urinary retention and kidney damage in particular can be serious health threats when they do occur.
Preparing for your appointment
You're likely to start by seeing your primary care doctor for urinary symptoms caused by an enlarged prostate. However, in some cases when you call to set up an appointment, you may be referred directly to a doctor who specializes in urinary issues (urologist).
Because appointments can be brief, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and know what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. For an enlarged prostate evaluation, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask any additional questions that come up during your appointment.
What to expect from your doctor
Tests and diagnosis
An initial evaluation for enlarged prostate will likely include:
Your doctor may use additional tests to rule out other problems and help confirm enlarged prostate is causing your urinary symptoms. These can include:
Other possible causes of urinary symptoms
Prostate cancer is entirely different than prostate gland enlargement, even though they can cause some similar symptoms and may be detected by some of the same tests. Having an enlarged prostate doesn't reduce or increase the risk of prostate cancer. Even if you're being treated for an enlarged prostate gland, you still need to continue regular prostate exams to screen for cancer. Surgery for prostate gland enlargement may identify cancer in its early stages.
Treatments and drugs
A wide variety of treatments are available for enlarged prostate. They include medications, surgery and minimally invasive surgery. The best treatment choice for you depends on several factors, including how much your symptoms bother you, the size of your prostate, other health conditions you may have, your age and your preference. If your symptoms aren't too bad, you may decide not to have treatment and wait to see whether your symptoms become more bothersome over time.
Any type of prostate surgery can cause side effects, such as semen flowing backward into the bladder instead of out through the penis during ejaculation (retrograde ejaculation), loss of bladder control (incontinence) and impotence (erectile dysfunction). Ask your doctor about the specific risks of each treatment you're considering.
Transurethral resection of the prostate (TURP)
Transurethral incision of the prostate (TUIP or TIP)
Minimally invasive surgery
Minimally invasive treatments include:
Laser surgery can be done with different types of lasers and in different ways.
Types of laser surgery include:
Options for laser therapy depend on prostate size, the location of the overgrown areas, your doctor's recommendation and your preferences. Choices available also depend on where you seek treatment. Not all facilities have lasers to perform prostate surgery or doctors who have the specialized skills and training to do the procedures.
Transurethral microwave thermotherapy (TUMT)
Transurethral needle ablation (TUNA)
Lifestyle and home remedies
Making some lifestyle changes can often help control the symptoms of an enlarged prostate and prevent your condition from worsening. Try these measures:
Studies on alternative therapy for an enlarged prostate have had mixed results. Sometimes these treatments appear to help, while other times, they don't. Saw palmetto extract, which is made from the ripe berries of the saw palmetto shrub, were believed to help reduce the symptoms of an enlarged prostate. But, research has found that the herbal treatment is no more effective than a placebo.
Because there's no strong evidence that any herbal treatment can relieve urinary symptoms caused by an enlarged prostate, the American Urological Association doesn't recommend any herbal treatments. In addition, certain herbal products may increase your risk of bleeding or interfere with other medications you're taking.
Some of the herbal treatments that have been suggested as helpful for reducing enlarged prostate symptoms include:
If you take any herbal remedies, be sure to tell your doctor. These may help treat some of your symptoms but are generally less effective than are prescription medications.
Last Updated: 2011-12-06
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