The prostate gland is part of the male reproductive system. It produces a fluid that is mixed with sperm to make semen. This gland surrounds the urethra and is located in front of the rectum and just below the bladder.
A normal prostate is about the size and shape of a walnut, but it can enlarge as a man ages. An enlarged prostate not caused by cancer is called benign prostatic hypertrophy (BPH), which can press on the urethra and make it harder to pass urine.
In the early stages of enlargement, the bladder can cope with a narrowed urethra by simply forcing the urine through. If the problem worsens, medical or surgical treatment may be required.
This condition should be monitored by your health care provider, as accumulation of urine in the bladder can cause infection which can progress to bladder damage and kidney (renal) failure. If needed, your health care provider may refer you to a specialist in kidney and prostate disease (urologist).
BPH is a common health problem in men older than 50 years. This condition is a normal part of aging; however, not all men will develop problems from this condition. If the enlargement grows away from the urethra, there will not be any compression of the urethra or resistance to urine flow.
- Not able to completely empty your bladder.
- Getting up often during the night to urinate.
- Need to urinate frequently during the day.
- Difficultly starting urine flow.
- Decrease in size and strength of urine stream.
- Dribbling after urination.
- Pain during urination (more common with infection).
- Inability to pass urine. This needs immediate treatment.
- Development of a urinary tract infection.
Common Tests For Diagnosis
- A thorough history and physical examination.
- A urination history, with the number of times you urinate, the amounts of urine, the strength of the urine stream, and the feeling of emptiness or fullness after urinating.
- A post void bladder scan that measures any amount of urine that may remain in your bladder after you finish urinating.
- Digital rectal exam. In a rectal exam, your health care provider checks your prostate by putting a gloved, lubricated finger into your rectum to feel the back of your prostate gland. This exam detects the size of your gland and abnormal lumps or growths.
- Exam of your urine (urinalysis).
- Prostate specific antigen (PSA) screening. This is a blood test used to screen for prostate cancer.
- Rectal ultrasonography. This test uses sound waves to electronically produce a picture of your prostate gland.
Of the men with BPH, one third will have symptoms that stabilize, one third will have symptoms that improve and one third will have symptoms that progress in the first year. Once symptoms appear, your health care provider will monitor your specific condition.
Mild symptoms may only require simple observation and yearly exams. Medicines and surgery are available for more severe problems. Your health care provider can help you make an informed decision for what is best.
- Medicines that shrink the prostate to relieve symptoms. These medicines take time to work, and it may be months before any improvement is seen.
- Uncommon side effects include problems with sexual function.
- Medicines to relax the muscle of the prostate to ease obstruction and reduce any compression on the urethra. These medicines work much faster than those that reduce the size of the prostate gland, with improvement noticed in days or weeks.
- Side effects can include dizziness, fatigue, lightheadedness, and retrograde ejaculation (diminished volume of ejaculate).
- Transurethral resection of the prostate (TURP)—An instrument is inserted through the opening at the tip of the penis to cut away pieces of the inner core of the prostate. The pieces are removed through the same opening to treat the obstruction and eliminate symptoms.
- Transurethral incision of the prostate (TUIP)—Small cuts are made in the prostate to lessen pressure on the urethra.
- Transurethral microwave thermotherapy (TUMT)—Microwaves create heat to remove a small amount of prostate tissue.
- Transurethral needle ablation (TUNA)—Radio frequencies are utilized to achieve the same effect as TUMT.
- Interstitial laser coagulation (ILC)—This procedure uses a laser to achieve the same effects as TUMT and TUNA.
- Transurethral electrovaporization (TUVP)—Electrodes are utilized to remove a small amount of the prostate tissue.
Contact a health care provider if:
- You develop a fever.
- There is unexplained back pain.
- Symptoms are not helped by medicines prescribed.
- You develop side effects from the medicine you are taking.
- Your urine becomes very dark or has a bad smell.
- Your lower abdomen becomes distended and you have difficulty passing your urine.
Seek immediate treatment if:
- You are suddenly unable to urinate.
- There are large amounts of blood or clots in the urine.
- Your urinary problems become unmanageable.
- You develop lightheadedness, severe dizziness, or you feel faint.
- You develop moderate to severe low back or flank pain.
- You develop chills or fever.
This information is not intended to replace advice given to you by your health care provider.