A man's prostate gland usually starts to enlarge after he reaches 40 years of age. This condition is called benign prostatic hyperplasia (BPH). The condition has also been referred to as benign prostatic hypertrophy.
The prostate gland secretes a fluid that helps to nourish sperm. The gland itself surrounds the urethra, which is the tube that carries urine from the bladder out through the tip of the penis. As the prostate grows larger, it may press on the urethra. This narrowing of the urethra can cause some men with prostate enlargement to have trouble with urination. Prostate enlargement may be the most common health problem in men older than 60 years of age.
The prostate gland, which is normally about the size and shape of a walnut, wraps around the urethra between the pubic bone and the rectum, below the bladder. In the early stage of prostate enlargement, the bladder muscle becomes thicker and forces urine through the narrowed urethra by contracting more powerfully. As a result, the bladder muscle may become more sensitive, causing a need to urinate more often and more suddenly.
The prostate grows larger due to an increase in the number of cells (hyperplasia). However, the precise reason for this increase is unknown. A variety of factors may be involved, including androgens (male hormones), estrogens, growth factors and other cell signaling pathways.
As the prostate grows larger and the urethra is squeezed more tightly, the bladder might not be able to fully compensate for the problem and completely empty. In some cases, blockage from prostate enlargement may cause repeated urinary tract infections and gradually result in bladder or kidney damage. It may also cause a sudden inability to urinate (acute urinary retention) -- a medical emergency.
Many men with an enlarged prostate have no symptoms. If symptoms are present, they commonly include the following:
If you experience fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospital's emergency department.
For acute symptoms such as acute urinary retention (you cannot urinate), you should immediately go to the closest emergency medical facility.
Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.
Once the diagnosis of prostate enlargement is made, your doctor may not recommend immediate treatment if symptoms are mild. Likely, one or more exams will be conducted per year to be sure that you are not developing any complications from prostate enlargement. Should your symptoms become more severe, both medical and surgical treatments are available.
Some precautions can help to avoid worsening of symptoms of prostate enlargement and complications.
Do not delay urination once you experience an urge. Urinate as soon as you feel the urge, and empty the bladder completely.
Watchful waiting: This conservative and often wise program of care is used because, for many men, symptoms can lessen without treatment. On the other hand, medications should be started early for moderate symptoms. Also, if there are complications or if symptoms are severe, your doctor may recommend surgery. For most men, the decision to treat the symptoms of an enlarged prostate is based on the patient's desire to improve his quality of life.