Enlarged Prostate

• What is the prostate?
• What causes an enlarged prostate?
• What are the symptoms of an enlarged prostate?
• How serious is an enlarged prostate?
• How is an enlarged prostate treated?
• What can I do to keep my prostate healthy?

By age 60, at least one-half of all the men in the U.S. will suffer from an enlarged prostate, a condition otherwise known as benign prostatic hyperplasia (BPH). By age 85, that number increases to 90%. For many men, BPH causes discomfort and difficulty urinating—in rare cases, it can indicate underlying conditions that pose a risk to your health.

Despite being a common condition, most men avoid talking about their prostate. Located near a man’s reproductive organs, it can often feel like a private and touchy subject. However, a reluctance to discuss these issues often leads men to neglect the health of their prostates and avoid treatments that can relieve symptoms of BPH.

What is the prostate? How serious is it when the prostate expands? Is there a treatment that can treat an enlarged prostate? We have answers that will help you understand the organ and how this common condition can affect your health.

The prostate is a walnut-sized gland in men located deep inside the groin between the rectum and the base of the penis.

While it may not be the first organ you think of when it comes to reproductive health, the prostate plays a vital role in the male reproductive system. The seminal vesicles sit on top of the prostate, creating and releasing seminal fluid that mixes with sperm for the ejaculatory process. 

Around it, you’ll find a rich array of blood vessels and nerves that run along either side of the prostate. These delicate structures play a role in sex, sexual health, reproduction, and—perhaps most importantly—urination.

Directly above your prostate is the bladder. The bladder accumulates urine, taking toxins and waste products from the body, which it expels through the urethra. This narrow tube flows from the bladder, runs through the middle of the prostate, and drains out the end of the penis. These systems are closely connected, which means that health issues with one can often affect how the others function. 

When the prostate enlarges it can put pressure on the delicate urethra and cause unpleasant symptoms, blocking the flow of urine from being expelled.

We don’t fully understand why prostates enlarge as they age. However, doctors believe it has something to do with testosterone and estrogen levels in the body, which may contribute to inflammation in the area.

Although we may not know precisely why prostates become enlarged, doctors have successfully mapped many of the risk factors that appear to affect prostate health. These include:

• Aging (men who are 60+)
• Genetics (a family history of enlarged prostates)
• Heart disease and diabetes, along with the use of beta blockers
• Lifestyle variables (obesity, smoking, and others)

While enlarged prostates are extremely common among individuals with these risk factors, there is not always a direct correlation between them and the condition.

Due to how common the condition is, many men experience symptoms of an enlarged prostate without realizing it. In fact, many assume the symptoms are an unavoidable consequence of aging and will ignore them without seeking treatment.

Learning how to identify the signs of an enlarged prostate can help you detect the condition early on, giving you the initiative to seek treatment before your issues worsen. 

The most common signs of a large prostate include:

• Urgent and frequent urination
• Difficulty urinating/an inability to empty the bladder
• Interrupted urination or a weak flow
• Increased need to urinate at night

While less common, some individuals may feel the need to urinate but not be able to, or will observe a rosy color in their urine, indicating the presence of blood. If you experience these symptoms, see your doctor immediately.

Although an enlarged prostate is often benign on its own, it can indicate the presence of other conditions:

• Prostatitis (inflammation of the prostate)
• Urinary Tract Infection
• Urethral Stricture (narrowing of the urethra)
• Bladder Scarring (often from prior surgeries)
• Kidney/Bladder Stones
• Nerve Complications in the Bladder
• Cancer (Bladder/Prostate)

How serious your condition is often reflected in the severity of your symptoms. As such, mild symptoms may not require immediate treatment. The more severe, the more likely treatment will be necessary.

The primary concern for men with enlarged prostates is a condition called acute urinary retention (AUR), which is the sudden inability to pass urine. The complete blockage of urine causes the bladder to distend and fill with fluid, leading to severe discomfort and health risks due to the build-up of toxins.

If you are unable to urinate, go to the ER immediately. A doctor will decompress the bladder by inserting a catheter, which should provide immediate relief by releasing the trapped urine. Once the bladder is empty, the doctor can then diagnose and treat your enlarged prostate.

Beyond the risk of AUR, having BPH can increase your likelihood of developing other complications, including:

• Urinary Tract Infections
• Bladder Stones 
• Bladder Injuries
• Kidney Damage 

While there is a risk, most men do not develop these secondary complications from an enlarged prostate. Also keep in mind that an enlarged prostate is not always a sign of cancer, and having BPH doesn’t increase your risk of developing the disease.

An enlarged prostate is treated with medications called alpha-blockers. These drugs relax the muscles that tighten, slow or stop the flow of urine from your bladder, helping your body excrete the buildup of fluid. 

In some cases, you may also receive 5-alpha reductase inhibitors. These drugs shrink the lemon-sized prostate back down to its normal size. 

The current alpha-blockers on the market include:

• Alfuzosin (Uroxatral)
• Doxazosin (Cardura)
• Silodosin (Rapaflo)
• Tamsulosin (Flomax)
• Terazosin (Hytrin)

The currently approved 5-alpha reductase inhibitors include:

• Dutasteride (Avodart)
• Finasteride (Proscar)

In combination, these medications are extremely effective at treating the condition in most men. However, some cases of BPH may be so severe as to require surgery. 

In these instances, doctors are increasingly using non-invasive surgical procedures. These include:

• Transurethral Resection of the Prostate (TURP) – a procedure that removes sections of the prostate that are restricting urine flow
• Transurethral Incision of the Prostate (TUIP) – small cuts into the gland to help reduce the pressure on the urethra without removing tissue
• Laser Surgery – precision beams target inflamed prostate tissue, shrinking the gland and restoring urine flow

Since we don’t know the exact cause of a large prostate, it can be difficult to know how to prevent the condition from developing as you age. However, there are some lifestyle changes you can make that may help:

• Consume less alcohol, particularly at night
• Reduce your consumption of artificial sweeteners
• Exercise regularly
• Cut back on caffeine and fizzy carbonated beverages

Along with making changes to your lifestyle, it’s important to see your doctor for routine prostate exams. These regular checkups will ensure your prostate remains healthy—by detecting prostate conditions early on, doctors can prevent them from becoming health risks while improving your quality of life by treating symptoms.

At AMA Medical Group, our experienced doctors offer comprehensive care for you and your family. From enlarged prostates to life-threatening heart conditions, our team is equipped to protect your health at every stage of your life. 

Find relief today. Request an appointment online or call us at 727-331-8740 to speak with one of our team members.