Prostate enlargement, also known as benign prostatic hyperplasia, is a common condition that affects older men. It is usually not a serious threat to health, but it can cause bothersome urinary symptoms. If it is left untreated, the prostate gland enlargement can impede the flow of urine out of the bladder and cause bladder, urinary tract or kidney problems.
The severity of symptoms varies, but they tend to gradually worsen over time. The size of the prostate does not necessarily mean the symptoms will be worse as well. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms. Sometimes the symptoms eventually stabilize and might improve over time. Common symptoms include:
- Frequent or urgent need to urinate
- Increased frequency of urination at night
- Difficulty starting urination
- Weak urine stream
- Dribbling at the end of urination
- Straining while urinating
- Inability to completely empty the bladder
Less common symptoms include urinary tract infection, inability to urinate and blood in the urine. In late stages, prostate enlargement can cause urine retention, bladder stones, bladder infections and damage to the kidneys.
It is not entirely clear what causes the prostate to enlarge. However, research suggests that hormones probably play an important role in the development of the condition and that it might be due to changes in the balance of sex hormones as men grow older. One theory is that as some men get older, the levels of a type of the hormone called dihydrotestosterone (DHT) increases, which may stimulate the growth of the prostate. Another theory suggests that prostate enlargement may be due to two hormones, testosterone and oestrogen. Younger men produce high levels of testosterone and much smaller levels of oestrogen. However, as men get older, their levels of testosterone decrease, which means they then have a higher proportion of oestrogen in their body. It has been suggested that the relative increase in oestrogen may stimulate prostate growth.
Risk factors for prostate gland enlargement include: aging, family history, ethnic background (prostate enlargement is less common in Asian men than men from other ethnicities), diabetes and heart disease and unhealthy lifestyle.
Serious complications are rare and having an enlarged prostate does not affect the risk of developing prostate cancer. Complications of enlarged prostate can include:
- Sudden inability to urinate
- Urinary tract infections (UTIs)
- Bladder stones
- Bladder damage
- Kidney damage
Most men with an enlarged prostate do not develop these complications. However, acute urinary retention and kidney damage can be serious health threats.
The best protection against prostate problems is to have regular medical checkups that include careful prostate exams, expecually if the person is experiencing a frequent urge to urinate, painful urination, bloody urine difficulty in urinating, or dribbling of urine.