Enlarged Prostate

Overview

An enlarged prostate, or benign prostatic hyperplasia (BPH), occurs when prostate cells multiply. As the prostate grows, it begins to push against the urethra, inhibiting the movement of urine through, and out of, the body. This pushing against the urethra leads to symptoms such as needing to urinate frequently, having trouble urinating or emptying the bladder completely, or having urine that stops and starts when you are trying to go.

Prostate enlargement is extremely common in men over the age of 60. The condition can be treated with medication and minimally invasive surgeries. People with mild symptoms may choose to forgo medical treatment, and focus on managing symptoms.

Enlarged prostate causes

When a prostate enlarges, its cells multiply. Over time, this growth pushes into the urethra, which inhibits the movement of urine through the urethra.

While the exact cause of enlarged prostates is not known, factors such as aging, cell changes in the testicles, and changing testosterone levels are thought to be involved.

Enlarged prostate risk factors

Anyone who has properly-functioning testicles is at risk of developing an enlarged prostate, although older age increases your risk significantly. The vast majority of men over age 80 have prostate enlargement, as well as a small number of men over the age of 40.

Other risk factors include:

• Having a family history of enlarged prostates
• Having diabetes
• Having heart disease
• Being obese

Enlarged prostate symptoms

Symptoms of an enlarged prostate include:

• A frequent need to urinate, including during the night or right after you just urinated
• Having trouble urinating when you try to go
• Feeling that your bladder is not completely empty right after urinating
• Urine that stops and starts when using the bathroom, or that continues to leak after urination

Enlarged prostate complications

An enlarged prostate can increase your likelihood of developing:

• Bladder stones
• Urinary tract infections
• Bloody urine
• Incontinence
• Trouble urinating
• Kidney damage

Enlarged prostate diagnosis

When diagnosing an enlarged prostate, your doctor may:

• Conduct a physical examination
• Review of your symptoms
• Perform a digital rectal exam
• Give a blood or urine test
• Provide a urinary flow test
• Provide a postvoid residual volume test
• Recommend keeping a journal of how often and how much you urinated, over several days

Enlarged prostate treatment

There is a wide range of treatments for an enlarged prostate. People experiencing mild symptoms may choose to forgo treatment altogether, and focus on managing symptoms. The following measures can improve symptoms caused by prostate enlargement:

• Avoid drinking liquids in the late evening to prevent bathroom trips in the middle of the night
• Avoid caffeine and alcohol
• Avoid antihistamines and decongestants
• Do not ignore the urge to urinate
• Try to use the bathroom at regular intervals
• Engage in regular physical activity, and try to lose weight if you are overweight
• Stay warm in cold weather, which can exacerbate the need to urinate

For many mild to moderate cases of prostate enlargement, medication is the first step**. These medications may include:

• Tadalafil, or Cialis
• Alpha blockers
• 5-alpha reductase inhibitors

**There is an earlier treatment option that can get men off BPH medications and avoid major surgery. In this minimally invasive procedure, a urologist uses a treatment to lift and hold the enlarged prostate tissue so it no longer blocks the urethra. This is the only BPH treatment that does not require heating, cutting, or removal of the prostate tissue. The procedure can be performed in a physician’s office or ambulatory surgery center using either local or general anesthesia.  

There is also a variety of minimally-invasive procedures to treat prostate enlargement, such as laser therapy.

When to seek care

Set up an appointment with your doctor if you are experiencing urinary issues, whether or not your symptoms are interfering with your daily life.

Next Steps

Long-term management of symptoms from an enlarged prostate may require trying different therapies, or changing therapies over time.

Seek immediate medical attention if you are unable to pass any urine at all.