Prostate enlargement
Male reproductive organs
What is prostate enlargement?
The prostate is a small, walnut-sized gland located between the pubic bone and rectum in men that contributes to the process of making seminal fluid. It surrounds the urethra at the opening of the urinary bladder. A common prostate problem is benign prostatic hyperplasia (also known as benign prostatic hypertrophy), or prostate enlargement. This usually starts to occur in men at about 50 years of age. The enlarged gland squeezes the urethra, causing problems in urinating. In some cases, urinary symptoms are caused by serious disorders of the prostate or bladder.
What are the symptoms of prostate enlargement?
- A difficulty in starting or stopping urination, dribbling of urine.
- A weak urine stream.
- A frequent and urgent need for urination, especially at night.
- A feeling that the bladder is not empty even after urinating (incomplete emptying).
- In some cases, severe lower abdominal pain due to urine retention.
Complications of prostate enlargement
- Bladder infection due to stagnant urine, as the bladder is not completely emptied.
- Bladder stones.
- Prostate enlargement affects quality of life because of frequent urination at night and incontinence.
- Rarely, if the urine outflow is severely obstructed and pressure builds up all the way back to the kidneys, it can impair kidney function.
What causes prostate enlargement?
The causes of prostate enlargement are not yet fully known, but are probably associated with the ageing process and dihydrotestosterone, a male hormone. Experts believe that dihydrotestosterone spurs the prostate's growth in adulthood.
What you can do?
Consult a doctor as soon as symptoms appear. In particular, see a doctor if your symptoms cause distress, are associated with abdominal pain, or if the urine is blood-stained. Once symptoms develop, they remain persistent. Without medical attention, the condition may worsen and cause distress.
Try to avoid medications and other substances that aggravate the condition. These can include alcohol, medications used to treat depression or Parkinson's disease, some heart drugs, and certain cough and cold remedies.
These other self-care tips may be of benefit.
- Avoid dampness and cold temperatures.
- Do not let your bladder get too full. Urinate as soon as the urge arises. Try to relax when urinating.
- When taking long car trips, make frequent stops to urinate.
- Whenever possible, sit on a hard chair instead of a soft one.
- Reduce your coffee and alcohol intake and avoid spicy foods if possible.
- Restrict the intake of fluids before going to bed.
- Reduce stress.
- Don’t smoke.
- Avoid over-the-counter antihistamine medications.
What your doctor can do for you
- Determine the cause of the symptoms and rule out other serious disorders.
- Perform a digital rectal examination (DRE) of the prostate. The doctor inserts a gloved finger up the rectum to feel the size and consistency of the prostate.
- Perform blood tests and urinary flow tests.
- Perform ultrasound examination of the kidneys and bladder for retained urine.
- Prescribe appropriate medications to help relax muscles at the bladder outlet or to cause the prostate to shrink.
- Perform surgery to relieve the symptoms.
Surgical treatment
There are several types of surgery available to treat this condition.
- Balloon dilation. This is done by inserting a balloon-tipped catheter into the penis through the urethra and into the bladder. The balloon is then inflated to stretch the urethra to allow urine to flow more freely.
- Transurethral resection of the prostate (TURP). In this procedure, a rigid tube is inserted into the urethra and a metal loop at its end is used to slice off excessive prostatic tissue. This is the most commonly undertaken type of prostate surgery. It relieves the symptoms by cutting out prostate tissue to reduce pressure on the urethra.
- Transurethral incision of the prostate (TUIP). This procedure also relieves the pressure on the urethra. It may be used in cases where the enlargement is not as pronounced.
- Minimally invasive surgical treatments. These usually use some form of heat, such as laser therapy, microwave therapy or trans-urethral needle ablation (TUNA), to reduce the size of the prostate and so relieve the pressure on the urethra. These treatments are not suitable for all men with prostate problems.
- Open prostatectomy.This is done when the prostate enlargement is very pronounced. An incision is made in the lower abdomen to remove part of the inside of the prostate.
Prostate surgery can result in complications such as impotence and/or incontinence, although this is rare for commonly used procedures such as TURP. Talk to your doctor or surgeon about the risks of surgery.
Last Reviewed: 10 May 2009
- 1. Urological Society of Australia. Benign prostatic hyperplasia (BPH) [accessed 2009, May 15]. Available at: http://www.urosoc.org.au/benign-prostatic-hyperplasia-bph/
2. Andrology Australia. BPH [updated 2005, Oct 11; accessed 2009, May 21]. Available at: http://www.andrologyaustralia.org/pageContent.asp?pageCode=BPH#AZBPHTREAT
3. MayoClinic.com. Prostate gland enlargement [updated 2007, Dec 14; accessed 2009, May 21]. Available at: http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027
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