What is an enlarged prostate?

An enlarged prostate, also commonly known as benign prostatic hypertrophy or BPH, is a common urological condition that affects millions of men over 50. As men age, the prostate gland (a walnut-sized organ in the male reproductive system), grows larger. In some men, the enlarged prostate presses on the urethra causing trouble with urination.

Common related conditions
Blood in Urine (Hematuria) Male Urinary Incontinence Urinary Incontinence in Women Prostatitis (Prostate Inflammation) Kidney Stones

Causes of an enlarged prostate

It is unknown why the prostate starts to enlarge, but research suggests it could be due to the balance of sex hormones as men age.

The prostate gland sits beneath the bladder, and the urethra passes through the center of it. As the prostate grows larger, it can significantly block urine flow.

Risks factors of an enlarged prostate

Risk factors for benign prostatic hyperplasia include:

  • Age
    As men age, they are more likely to develop BPH. More than half of men over 80 have symptoms from the condition.
  • Family history
    If your father or brother (blood relatives) have prostate conditions including BPH, you are more likely to develop the prostate conditions.
  • Chronic conditions
    Chronic conditions such as diabetes and heart disease can increase your risk of developing BPH.
  • Obesity
    Being overweight makes you more likely to develop BPH as you age.

Symptoms of an enlarged prostate

Symptoms of an enlarged prostate vary depending on the severity of your condition. Common symptoms of an enlarged prostate include:

  • Increased need to urinate at night
  • Difficulty starting to urinate
  • Weak urine stream
  • More frequent urination or sudden need to urinate
  • Blood in urine (hematuria)
  • Sense of not fully emptying bladder after urinating

Diagnosis of an enlarged prostate

An enlarged prostate can be diagnosed by your primary care provider or urologist. Your physician will perform a digital rectal exam to determine if other urological problems are causing your symptoms. During a rectal exam, your doctor will insert his or her finger into the rectum to feel the prostate. The doctor will be able to determine the size and consistency of the prostate during this exam.

If your doctor suspects an infection, you may also have a urinalysis. You may also have a blood test to check for kidney problems or a PSA (prostate-specific antigen test) to test for prostate cancer.

Treatment for an enlarged prostate

Treatment for BPH varies depending on the severity of your condition.

Medication options include:

  • Alpha blockers
    Alpha blockers help men urinate easier.
  • 5-alpha reductase inhibitors
    5-alpha reductase inhibitors help shrink the prostate.
  • Combination drug therapy
    Taking an alpha blocker and 5-alpha reductase inhibitor together.
  • Tadalafil (Cialis)
    Typically used to treat erectile dysfunction, they can also treat BPH.

Surgical options include:

  • Prostatectomy
    A prostatectomy is a commonly performed procedure that removes part of the prostate. Surgical correction of an enlarged prostate has the largest number of complications, so it should only be considered when other options have failed.
  • Transurethral prostatectomy (TURP)
    A transurethral prostatectomy is the most commonly used treatment for BPH. During a TURP procedure, the core of the prostate is removed to shrink the prostate. Most men experience symptom relief from this procedure.
  • Transurethral incision of the prostate (TUIP)
    During a transurethral incision of the prostate, your urologist will relieve pressure on the urethra by making small incisions on the prostate gland. Not everyone is a candidate for this procedure.
  • Open prostatectomy
    If the prostate is very large, your doctor may recommend an open prostatectomy. During an open prostatectomy, large prostatic nodules are removed through the bladder. Complications from an open prostatectomy are common, so this is used as a last resort.

Recovery from an enlarged prostate

Unfortunately, there is not a cure for an enlarged prostate. As men age, the prostate will continue to get larger. Most men will find relief with medications. If surgery is necessary, recovery will depend upon the surgical option that your doctor recommends.

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