Enlarged Prostate Symptoms and Causes
In men, urine flows from thebladderthrough the urethra. Prostate gland enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra — the “chute” through which urine and semen exit the body.
As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.
Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.
Symptoms of enlarged prostate can include:
- A weak or slow urinary stream
- A feeling of incomplete bladder emptying
- Difficulty starting urination
- Frequent urination
- Urgency to urinate
- Getting up frequently at night to urinate
- A urinary stream that starts and stops
- Straining to urinate
- Continued dribbling of urine
- Returning to urinate again minutes after finishing
When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones,blood in the urine, incontinence, and acute urinary retention (an inability to urinate). A sudden and complete inability to urinate is a medical emergency; you should see your doctor immediately. In rare cases, bladder and/orkidney damage can develop from BPH.
Time to Do Something About Your Enlarged Prostate?
Most men put up with an enlarged prostate for months, even years, before seeing a doctor, says Slawin. “When they’re getting up several times a night, and have trouble falling asleep again, that’s when they come in,” he tells WebMD.
It’s not always obvious what’s going on, Slawin adds. “When men start having urinary problems, it’s hard to know the reason. They should see a doctor when anything changes, because there can be bladder cancer, stones, prostate cancer. BPH is often a diagnosis of exclusion … after we make sure nothing more serious is going on.”
Urologists use the BPH Impact Index, a symptom questionnaire developed by the American Urological Association to determine if a man’s symptoms from BPH require treatment. “It helps us understand how severe the problem is,” says Slawin. Higher scores indicate more severe symptoms.
Prostate growth — and the trouble it causes — varies greatly from person to person, says O. LenaineWestney, MD, division director of urology at The University of Texas Medical School at Houston. “Some people have more growth than others. Some people with very large prostates don’t have trouble with voiding. It’s a very individual thing.”
Watchful Waiting With an Enlarged Prostate
When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index (less than 8), it may be best to wait before starting any treatment — what’s known as “watchful waiting.”
With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience. That’s where the BPH Index is especially helpful, Westney tells WebMD. “It lets us know how high the symptom score is … when to start treatment.”
The “driving force in treatment,” she explains, is whether the symptoms are affecting your quality of life — and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure, or other bladder problems.
A few questions to ask yourself:
- How severe are your symptoms?
- Do symptoms prevent you from doing things you enjoy?
- Do they seriously affect your quality of life?
- Are they getting worse?
- Are you ready to accept some small risks to get rid of your symptoms?
- Do you know the risks associated with each treatment?
- Is it time to do something?