Basic Facts

• An enlarged prostate, also called benign prostatic hyperplasia, is the non-cancerous growth of the prostate that often occurs as men age.
• The male hormone, testosterone, is related to the tissue overgrowth.
• About half of men with an enlarged prostate will need treatment.

The prostate is a walnut-sized organ that surrounds the lower part of a man's bladder in front of the rectum. The prostate makes the fluids in semen that feed and transport sperm. As men age, it is common for the prostate to enlarge.

What are the symptoms?

The common symptoms of an enlarged prostate include:

• Difficulty urinating or a weak urinary stream;
• Stopping and starting during urination or significant dribbling after urination;
• Incomplete emptying of the bladder;
• Having to urinate again shortly after urination;
• Frequent urination, especially at night;
• Urgent need to urinate; and
• Blood in the urine.

Causes and risk factors

It isn't known what causes prostate enlargement. Risk factors include:

• Age;
• Race;
• Family history; and
• Marital status (married men have higher rates of enlarged prostate than unmarried men).

Diagnosis

Physicians typically use a quick test to diagnose and assess the severity of an enlarged prostate. The test, known as the International Prostate Symptom Score, asks the patient to assess the frequency of urinary symptoms in the past month. A urine flow study, which measures the strength of the urinary stream, may also be ordered.

Physicians will also perform a digital rectal exam and a prostate specific antigen (PSA) blood test to screen for prostate cancer. An elevated level of PSA in the blood stream indicates a higher risk for prostate cancer.

Treatment Approaches

Treatment for enlarged prostate depends on the severity of symptoms.

If symptoms are mild, many physicians recommend watchful waiting, which means scheduling regular examinations to evaluate the prostate rather than actually treating it.

Moderate symptoms may require drug treatment. Alpha blockers relax the muscles around the urethra, allowing full urine flow. Finasteride can reduce the size of the prostate. According to research, an extract of saw palmetto berry (an herb that is available over the counter) also treats prostate enlargement and improves urinary symptoms.

Bothersome symptoms may prompt surgery, such as the following procedures:

• Photo Selective Vaporization of the prostate PVP (Green Light Laser)
• Transurethral needle ablation, or TUNA.
• Transurethral resection of the prostate, or TURP;

Lifestyle

Adopting certain habits can reduce the symptoms of enlarged prostate. Physicians may recommend limiting the consumption of beverages in the evening; reducing the consumption of alcohol, which stimulates urination and irritates the bladder; and exercising regularly.