As men age, the prostate enlarges or tightens, resulting in symptoms such as difficulty urinating, frequent urination, bladder stones, recurrent urinary tract infections or blood in the urine. Enlarged prostate, also called benign prostatic hyperplasia (BPH), is commonly diagnosed in men. By age 50, 25% of men will experience symptoms of BPH, with half of all men developing BPH symptoms by the age of 70.
BPH can significantly impact your quality of life, but The University of Kansas Health System can help. Our team offers comprehensive diagnosis, treatment and management of enlarged prostate for men in the Kansas City metro region and throughout the state of Kansas.
What is BPH?
A man’s prostate naturally grows in size with age. The first time this occurs is early in puberty, and the second time this occurs is in the mid-20s. Prostate growth continues throughout a man’s life. While the prostate will typically stay the size of a walnut, it can continue to grow over time and push down on your urethra, which is the tube that moves urine from the bladder outside of the body. This condition is called enlarged prostate or BPH.
BPH is a chronic progressive condition. Although it’s not considered dangerous since it is not a precursor to cancer, BPH symptoms can affect quality of life. If BPH symptoms become severe and remain untreated, they can cause more serious health concerns such as the inability to urinate, urinary tract infections, bladder stones, urinary incontinence, bladder or kidney damage.
Enlarged prostate symptoms and risks
As the prostate enlarges and pushes on the urethra, urinary issues may begin to develop. These symptoms can include, but are not limited to:
- Difficulty starting urination
- Dribbling at the end of urination
- Frequent urination
- Sensation of incomplete emptying of the bladder
- Urine stream that starts and stops
- Waking up at night to urinate
- Weak urinary stream
Call your doctor immediately if you become incontinent and cannot control urination, experience pain or a burning sensation when urinating or discover blood in the urine.
A man’s age has an effect on his prostate. Family history can also play a significant role in the development of BPH.
If a man’s father or brothers have had an enlarged prostate, there is a higher risk that he will develop the same issue. In addition, Caucasian and African-American men have a higher risk of experiencing BPH problems compared to Asian men.
Prostate enlargement diagnosis and screening
There is no specific test for an enlarged prostate. Your physician will complete a physical exam, and may also perform other initial tests to diagnose an enlarged prostate:
- A DRE is a digital rectal exam performed by the doctor using a lubricated glove. As the man bends forward or lies on his side, the doctor inserts one finger into the rectum to feel the prostate and determine if it has an abnormal shape or thickness.
- A PSA blood test looks for levels of a protein-specific antigen found only in the prostate gland. This protein should be at a low level for a healthy prostate. Higher levels can indicate an inflammation known as prostatitis, BPH or prostate cancer. This is a routine test for men over age 50.
- A urine test will rule out any infection or other issue.
Your doctor may order some additional tests. Among them are a uroflowmetry test, measuring how fast the urine flows, a PVR or postvoid residual test to determine how much urine is left in the bladder after urination, an ultrasound of the prostate, plus others.
Enlarged prostate treatment
Treatment options depend on your general health, severity of symptoms and size of the prostate. There are a number of treatment options available to help ease symptoms, but it is important to understand the details of each specific treatment and consult with your doctor before making a final decision:
- Combination therapy combines two drugs (namely an alpha blocker and an inhibitor) together to relax the bladder muscles and relieve symptoms of BPH.
- Oral medication can improve urine flow and reduce symptoms.
- Prostatic artery embolization (PAE) is a minimally invasive nonsurgical treatment for BPH.
- Rezūm® water vapor therapy is an in-office procedure that uses steam to remove prostate tissue blocking the flow of urine from the bladder.
- Thermotherapy applies heat energy to the prostate tissue.
Holmium laser ablation (HoLAP) and homium laser enucleation of the prostate (HoLEP) are minimally invasive surgical alternatives to the removal of the prostate for long-term resolution of BPH symptoms:
- HoLAP: During a HoLAP procedure, your surgeon will guide a laser to heat and remove any blockages with the aim of improving or resolving any urination symptoms.
- HoLEP: For a HoLEP procedure, a secondary tool is used in conjunction with the laser to cut the excess tissue for removal. Cutting and removing the excess tissue also allows pathologists to examine the sample for prostate cancer if needed.
If other treatment options are not successful, your doctor may recommend prostate surgery.