Conditions

Treatments

Enlarged Prostate

Description

Enlarged prostate, or benign prostatic hyperplasia (BPH) is a noncancerous condition that is extremely common in men. In fact, men can start to have microscopic findings of prostate enlargement in their 30’s. Many men aged 50 and older suffer from symptoms related to enlarged prostate. Commonly, this condition is misspelled as enlarged prostrate.

Symptoms

Many men with enlarged prostate do not have any symptoms. However, when men do have symptoms, they are commonly referred to as LUTS, or lower urinary tract symptoms. Patients may complain of hesitancy (having a slow or interrupted urinary stream) urinary frequency, as well as urinary urgency (having the sudden need to urinate quickly). These symptoms are thought to occur both because of the prostate enlargement as well as changes in the bladder that occur. Because the bladder has to work harder to empty against a larger prostate, the bladder can become thickened and irritable, contributing to all of these symptoms.

Diagnosis

The digital rectal examination plays an important role. The physician will be able to estimate prostate size, as well as assess for any prostate nodules. Transrectal ultrasound (TRUS) can give a more precise measurement of the prostate. Urinalysis and urine culture may be performed to make sure that the patient does not have a urinary tract infection. A PSA test is typically performed because men who present symptoms from BPH are usually candidates for prostate cancer screening. Diagnostic procedures can include uroflow, which measures the urine flow rate, as well as cystoscopy, in which a small scope is passed into the bladder.

Treatment

BPH can be treated with medicine or with procedures. Medical treatment (alpha blockers and 5-alpha reductase inhibitors) work by either relaxing the urethra that is within the prostate, or by shrinking the prostate itself. Many patients can be treated successfully by either of these types of medications. Procedures to treat BPH are aimed at removing the obstructive tissue. These include thermotherapy (microwave therapy), GreenLight laser ablation, and transurethral resection of the prostate (TURP)

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