The prostate is an organ in the body that helps to produce some of the liquid during ejaculation. The prostate gland surrounds the urethra, which is the passageway by which urine leaves the body. Enlargement of the prostate is an indication that the gland has grown in size. Almost all men experience prostate enlargement as they age. The condition is often referred to as BPH (benign prostatic hyperplasia). The condition is not cancerous.
Associated Anatomy of Enlarged Prostate
Causes of Enlarged Prostate
- It is unclear what causes prostate enlargement.
- With age, the probability of acquiring an enlarged prostate increases.
- Many males over the age of 40 have some degree of prostate enlargement. But usually develop symptoms after the age of 50.
- More than 90% of males over the age of 80 have the disorder.
Signs or Symptoms of Enlarged Prostate
These are the most common symptoms of enlarged prostates:
- Weak urine flow and the feeling your bladder has not been emptied completely.
- Starting to urinate is difficult
- Dribbling of urine after urination.
- More frequent urination, especially at night
- Frequent urge to pee
It is possible to experience none of these symptoms, even if your prostate is enlarged. Other factors, such as cold weather, anxiety, other health issues, and certain medications, can also cause these symptoms. Blood in the urine can be a sign of an enlarged prostate. This is not common and is typically caused by something else.
Possible Treatment of Enlarged Prostate
The following are the three primary forms of therapy for an enlarged prostate:
A. Modifications in lifestyle
There are several basic changes you may make to your lifestyle that may help your symptoms.
- Reduce your intake of alcohol, caffeine, artificial sweeteners, and fizzy drinks.
- Before leaving the house, make sure your bladder is empty.
- Consume more fruits and vegetables.
- Maintain a healthy weight Stop smoking
- Regular exercise is essential.
The use of medications may be an option if lifestyle changes do not alleviate your symptoms. The most commonly prescribed medications are:
- Inhibitors of 5-alpha-reductase
Surgery may be an option if your symptoms don't improve with lifestyle changes or medications. The most common types of surgery are:
- Prostate transurethral resection
- Prostate transurethral vaporization
- Laser surgery
- Urethral prostatic lift
- Open simple prostatectomy
Risk Factors of Enlarged Prostate
You are more likely to develop an enlarged prostate if you have the following risk factors:
A. Age: An enlarged prostate is more likely to occur as you grow older.
B. Hormone levels: The hormones (estrogen and testosterone) in your body change as you age. It may cause the prostate to enlarge.
C. Other risk factors: Obesity and diabetes are known to be associated with a high risk of enlarged prostate. Patients with a family history are also more likely to develop the condition.
Typical Test for Enlarged Prostate
Your doctor will ask you questions about your medical history. A digital rectal exam will be performed to feel the prostate gland. The following tests may also be performed:
- Urine flow rate
- A residual urine test: It measures how much urine is left in your bladder after you urinate.
- Pressure-flow investigations are used to determine the pressure in your bladder when you pee.
- Urinalysis Urine culture: To detect if there is any infection
- Prostate-specific antigen (PSA) blood test: To screen for prostate cancer
- Cystoscopy in certain specific condition
- Creatinine and blood urea nitrogen (BUN) testing
Primary Prevention of Enlarged Prostate
The experts say there is no way to prevent benign prostatic hyperplasia. Men who are at risk of enlarged prostate should consult their doctor if they experience any lower urinary tract symptoms and whether they should undergo frequent prostate exams. Patient with family history of Prostate cancer should come early for screening to mitigate the risk.
Secondary Prevention of Enlarged Prostate
The following steps can help in the secondary prevention of mild symptoms:
- Pee as soon as you feel the desire. Also, use the restroom whenever possible, even if you don't feel the urge to urinate.
- Avoid drinking and using caffeine, especially after dinner.
- Drinking a lot of fluid all at once is not a good idea. Distribute fluids throughout the day.
- Avoid consuming fluids within two hours of going to bed. Avoid using over-the-counter cold and sinus drugs containing decongestants or antihistamines. These drugs have the potential to exacerbate enlarged prostate symptoms.
- Maintain a healthy level of fitness by staying warm and exercising on a regular basis. The combination of cold weather and a lack of physical activity may aggravate symptoms.
- Pelvic strengthening exercises should be learned and practiced.
- Reduce your tension. Increased urination can be caused by nervousness and strain.
Differential Diagnosis for Enlarged Prostate
Overactive bladder (OAB), bladder cancer, foreign things in the bladder (stones or stents), Prostate Cancer and urethral stricture due to trauma or a sexually transmitted illness are some of the differential diagnoses for an enlarged prostate.
Enlarged Prostate Epidemiology
According to the findings of an age-related study, the prevalence of enlarged prostate increased with age from 14% in those aged 50-59 years to 30% among those aged 60-69 years and 44% among those aged 70-79 years. The risk of BPH is 41% higher in Black and Hispanic men compared to white men.
Enlarged Prostate Expected Prognosis
The early recognition of bladder symptoms and the identification of enlarged prostate gives men the opportunity to receive early treatment and limit its consequences.
Enlarged Prostate Pathophysiology
A prostate enlargement results from an increase in the size of the prostate. It is called as Benign Prostate Enlargement (BPE) on clinical examination and benign prostate hyperplasia (BPH) after histopathological confirmation. It is either due to an increase in the size of the prostate or an increase smooth muscle tone of Prostate.
Possible Complications of Enlarged Prostate
When a man has an enlarged prostate and whose symptoms have gradually worsened over a long period of time, he may develop the following complications:
- Infections of the urinary tract (UTIs): The inability to completely empty the bladder might raise the risk of urinary tract infection.
- Stones in the bladder: In most cases, this is caused by an inability to empty the bladder. Bladder stones can result in infection, bladder discomfort, blood in the urine, and urinary flow restriction.
- Damage to the bladder: A bladder that hasn't been fully emptied might expand and weaken over time.
- Kidney failure. Urinary retention can cause bladder pressure, which can directly harm the kidneys or allow bladder infections to reach the kidneys.
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