Benign Prostatic Hyperplasia (Enlarged Prostate)
As men age, their prostates continue to grow, but enlargement doesn’t usually cause problems until late in life.
An enlarged prostate rarely causes symptoms before age 40, but more than half of men in their 60s and as many as 90% in their 70s and 80s have some issues. The most common symptoms involve changes or problems urinating – such as a hesitant, interrupted, weak stream, leaking or dribbling, or more frequent urination, especially at night.
If you believe you may have an enlarged prostate, you need to be checked by a urology specialist. We will conduct various tests to identify problems. Enlarged prostate treatment varies from patient to patient and can involve medication or minimally invasive therapies such as ultrasound or ablation.
Benign prostatic hyperplasia (BPH), is a condition caused by an enlarged prostate and usually affects aging men. The prostate surrounds the urethra just below the bladder. As the prostate enlarges, it can squeeze the urethra and can irritate or block the bladder, causing men to have trouble urinating.
- The frequent need to empty the bladder, as often as every one to two hours, especially during night
- A feeling that the bladder is not empty, even after urinating
- A weak urine stream or dribbling
- An inability to delay urination once the urge to urinate arises
- Trouble starting to urinate, often requiring you to push or strain to urinate
- The need to stop and start urinating several times when the bladder is emptied
- In extreme cases, not being able to urinate at all. This is an emergency, and you should seek attention immediately.
- Increasing age
- A family history of BPH
- Evaluation – a review of medical history, a physical examination (including a digital rectal exam), and use of the American Urological Association BPH Symptom Score Index (a score based on answers to questions about symptoms)
- Urinalysis (urine test)
- There are other studies that may be used, depending on your situation. These include:
- Prostate specific antigen (PSA) — a blood test to screen for prostate cancer
- Urinary cytology — a urine test to screen for bladder cancer
- Measuring post-void residual volume (PVR) — the amount of urine remaining in the bladder after urinating
- Uroflowmetry (urine flow study) — to measure urine flow
- Cystoscopy – viewing the urethra and/or bladder using a small flexible scope
- Urodynamic pressure – a flow study that tests the inside bladder pressure during urination
- Ultrasound of the kidney or the prostate
Various medications treat BPH symptoms. In some men, a combination of drugs may work best. If diagnosed, we will discuss all options. Together, we can decide whether medication, minimally invasive therapy or surgical treatment is best for you.