• decreaseincrease
  • pdf

Enlarged Prostate Symptoms and Treatment

Enlarged prostate, also known as benign prostatic hyperplasia or BPH, occurs more often than men may think. “It’s a very common disease in men, and one of the top five diseases we see at our clinic,” says Dr. C. Mark Jackson, a urologist at Washington Regional’s Ozark Urology Clinic.

By age 40, he says, about half of all men will have some form of BPH; by age 80, about 90% of men will be affected.

The prostate is part of a man’s urinary tract system. The urethra, a tube-like structure that carries urine out of the body, goes through the prostate. The prostate is also part of a man’s reproductive system and produces seminal fluid. Therefore, it has a strong relationship to the hormone testosterone. “Once a male experiences a surge of testosterone at puberty, the prostate begins to grow and continues to grow throughout his lifetime,” Jackson says.

This continual growth of the prostate can lead to complications, such as:

Bladder damage: When the prostate grows, it begins to restrict the urethra, making it difficult for the bladder to empty, Jackson says. “It increases the pressure in the bladder and that’s where a lot of BPH problems come from. The bladder muscle thickens and becomes very muscular to get that urine out. This increased pressure can cause damage in the bladder between the muscle fibers.”

Blood: Blood vessels in the prostate are very fragile and can rupture from pressure created by urination; this can cause blood in the urine. Jackson says these blood vessels do not clot well after rupturing; instead, they can grow large enough to restrict urine flow to the point of needing catheterization.

Infection: “Poor or incomplete emptying of the bladder can lead to recurrent urinary tract infections,” he says. “These can be difficult to treat because bacteria are not eliminated in the urine stream and antibiotics really don’t have a chance to work well.”

Stones: Infections can cause bladder stones, as can naturally occurring salt in urine. “The stones can become so large you can’t pass them through the urine stream. They sometimes require laser surgery or robotic surgery,” Jackson says.

Urinary retention: “When you have a bladder full of urine, and you have kidneys draining urine into that full bladder, you can get backup,” he says. “That can cause renal blockage, which can lead to renal failure and, ultimately, the need for dialysis.”

To avoid these complications, Jackson says, it’s important to recognize these symptoms of enlarged prostate or BPH:

  • Nocturia, or waking frequently at night to urinate
  • Weak urine stream
  • Urination frequency
  • Urination urgency; having to rush to the bathroom
  • Difficulty starting a urine stream
  • Experiencing start-stop of urine stream
  • Post-void dribbling that leaves clothing damp

“Treatment really begins by seeing your primary care provider at least once a year,” Jackson says. Your provider may perform a prostate exam or blood test called PSA — prostate specific antigen — as well as a blood test to check kidney function and a urine test to rule out infection or blood in the urine.

“If your prostate exam is abnormal or if any of your other tests are abnormal, your primary care provider may suggest you see us for further testing,” he says. “If your PSA is high, we may recommend an MRI to get a better look at the anatomy of the prostate.”

There are many effective medications to relieve the bothersome symptoms of BPH, Jackson says, as well as minimally invasive surgical options for more severe cases. Above all, he recommends that a man take action if he experiences any BPH warning signs. “Prevention is key to avoiding bladder or urinary tract damage,” he says.

“And remember, this is a very common problem that we see every day. And there are solutions. You shouldn’t have to live with BPH, and you shouldn’t have to worry where the nearest bathroom is.”

Request an appointment at Washington Regional Ozark Urology Clinic.