An enlarged prostate, clinically referred to as benign prostatic hyperplasia (BPH), is especially common in men 50 and older. By age 60, more than 50% of men have one; the condition affects urinary function as the prostate grows. The prostate gland presses on the urethra, which disrupts normal urine flow and contributes to urinary symptoms.
Recognizing Enlarged Prostate Symptoms
An enlarged prostate produces a range of urinary symptoms. Frequent or sudden urges to urinate are common; an increased need to urinate at night often accompanies them. Difficulty starting urination, a weak stream that stops and starts, and dribbling at the end of urination are reported signs, while some men also find it difficult to empty the bladder completely.
Symptoms vary among individuals. Some men experience several urinary changes, while others have fewer symptoms. When an enlarged prostate affects the urethra, urinary flow changes; these changes can include difficulty starting or maintaining a stream.
Identifying Risk Factors
Several factors raise the likelihood of developing BPH. Men 50 and older face a higher risk; a family history that includes a father or grandfather with the condition adds to that likelihood. Diabetes, heart disease, and obesity are also associated with a higher risk of developing an enlarged prostate.
Diagnosing the Condition
Diagnosis follows a structured process. A provider reviews the patient’s symptoms and performs a digital rectal exam to assess the prostate, while blood work checks for kidney problems; a urinalysis identifies other potential causes. A prostate-specific antigen test measures PSA, a protein produced in the prostate; elevated PSA levels can have several causes.
When initial tests do not provide enough information, a provider orders additional evaluations. A urinary flow test measures the strength of the urine stream and the amount of urine passed, while a postvoid residual volume test measures urine remaining in the bladder after urination. The remaining urine is measured with ultrasound imaging or a catheter placed in the bladder after urination.
Reviewing Treatment Options
Treatment depends on prostate size, patient age, overall health and symptom severity. Medication is used for mild to moderate symptoms, and three medication categories include alpha blockers, 5-alpha reductase inhibitors and combination therapy. Alpha blockers relax muscles in the bladder neck and prostate, while 5-alpha reductase inhibitors reduce prostate size by blocking hormone changes that cause growth.
When medication does not provide adequate relief, surgical or procedural options are available. These include transurethral resection of the prostate, laser therapy, transurethral microwave thermotherapy, a prostate lift, water vapor thermal therapy and prostate artery embolization. The provider selects a procedure based on individual circumstances, and prostate size and health history help guide that decision.
Managing Symptoms at Home
Lifestyle adjustments help manage urinary symptoms alongside medical treatment. Caffeine and alcohol can increase urine production, irritate the bladder and worsen symptoms, so limiting both is recommended. Avoiding fluids for one to two hours before bedtime reduces nighttime urination, while double voiding involves urinating, pausing briefly and urinating again to help empty the bladder more completely.
Seek a Urology Evaluation
An enlarged prostate affects urinary function, and evaluation helps identify the cause of urinary symptoms. A urologist assesses symptoms and determines the appropriate diagnostic approach, while treatment options depend on the patient’s condition. Evaluation provides a basis for selecting an appropriate management strategy when BPH symptoms affect urinary function.
