Special to The Island News
For young men, the prostate usually doesn’t cause any problems. However, as men age, the prostate gradually gets larger, and some men develop a condition called benign prostatic hyperplasia (BPH), or an enlarged prostate.
BPH mostly affects older men. About 50% of men ages 51 to 60 and up to 90% of men over age 80 have symptoms of BPH. Experts aren’t sure exactly what causes the condition, but it may be related to hormonal changes that occur as men age.
Other factors besides hormones can increase the likelihood of a man developing BPH. Those factors include:
- Being age 40 or older.
- Certain medical conditions, such as obesity, heart disease and Type 2 diabetes.
- Erectile dysfunction.
- A family history of BPH.
- Lack of physical activity.
As the prostate gets bigger, it presses against the urethra, the tube through which urine flows out of the bladder. Over time, the bladder muscles can get weaker, and you might not be able to empty your bladder completely.
Other symptoms of BPH can include:
- Frequent urination, defined as urinating eight or more times per day and having to urinate frequently while sleeping.
- Having urine with an unusual smell or color.
- Pain when urinating or after ejaculation.
- Trouble starting a urine stream or having a weak urine stream.
- Urinary urgency, incontinence or retention.
“You may be tempted to ignore symptoms, especially if they are only mild,” says Dr. Louis Plzak III, a board-certified urologist with Beaufort Memorial Urology Specialists. “However, BPH may increase the risk of developing urinary tract infections, acute urinary retention (inability to urinate), bladder stones and kidney damage.”
In addition, although BPH does not increase the risk of getting prostate cancer, its symptoms can mimic those of prostate cancer, so it’s important to see a provider if you experience them.
Your provider will talk to you about your personal and family medical history and may also perform a physical exam and a digital rectal exam, which is a physical exam of the prostate.
A review of your symptoms and a physical exam are usually enough for a diagnosis of BPH. However, your provider may refer you to a urologist, who might perform other tests, including:
- A urinalysis — A urine sample will be evaluated for signs of infection.
- Prostate-specific antigen (PSA) blood test — This test shows levels of PSA in the blood. High levels can indicate BPH or another problem with the prostate, such as an infection or prostate cancer.
- Urodynamic tests — These tests help the urologist determine how well the urethra and bladder store and release urine from the body.
- Cystoscopy — For this procedure, a urologist inserts a narrow tube called a cystoscope into the penis to evaluate the urethra and bladder.
- Transrectal ultrasound — A type of imaging exam that uses sound waves, this test involves a trained technician inserting a wand into the rectum and taking images of the prostate. Your urologist will review the images to see the size of the prostate and look for abnormalities.
Your provider may recommend lifestyle changes, such as:
- Avoiding caffeine and alcohol as well as certain medications, such as decongestants and antidepressants.
- Doing pelvic floor exercises.
- Reducing intake of liquids, especially before going to bed or going out in public.
If your symptoms affect your quality of life, your doctor can prescribe medications that may help. Medications can relax your prostate and bladder muscles or improve urine flow, so you can reduce symptoms related to urination. Other medications can shrink the prostate or treat erectile dysfunction.
When medication and lifestyle changes are not enough, your urologist might recommend a minimally invasive procedure or surgical treatment to reduce the size of the prostate or widen the urethra.
Your urologist will help you decide on the best treatment for you. The bottom line, however, is that BPH is treatable, and you have many options to choose from, so you can live without symptoms and get back to enjoying your life.
