Prostate Enlargement

What is prostate enlargement?

The prostate is a small organ or structure found at the base of the bladder, which is made up of muscle fibres and glands. The main function of the glands is to produce fluids that are mixed with sperm to help the sperm fertilise an egg. Prostate enlargement or benign prostatic hyperplasia is an increase in the size of the prostate gland. This enlargement of the gland is not because of cancer but simply an increase in the number and size of the normal cells within the prostate. Prostate enlargement is very common - it starts after the age of forty and affects probably every man as they age.

Causes

The causes are not well known. The enlargement or growth of the prostate gland is a normal process as men get older. It may be associated with difficulty passing urine and sometimes prostate disease.

Symptoms

A number of men with enlarged prostates do not have any symptoms and some men with small prostates can have urinary symptoms. 

Lower urinary tract symptoms are a group of symptoms related to difficulty passing urine, which are sometimes related to an enlargement in the prostate gland.  Symptoms can be either irritative or obstructive, that is, some of the symptoms are related to an irritation in the bladder and some of the symptoms are related to difficulty passing urine. Men with lower urinary tract symptoms typical describe urgency, frequency and going to the toilet at night.  The obstructive symptoms are difficulty getting urine to flow from the penis, a weak or poorly directed stream of urine, straining to pass urine and dribbling after urinating has finished. Rarely, the symptoms of difficulty urinating are related to cancer but, usually, most men who find it difficult to urinate do not have cancer

Diagnosis and treatment

Treatment options depend on the severity of the symptoms and range from medication to having surgery. 

Medications work by either relaxing the muscles in the prostate or by reducing the size of the prostate. Medications to relax the muscles in the prostate are called alpha blockers. They work very quickly, but can cause side effects such as light-headedness, dizziness or tiredness. Finasteride is a medicine which works in a different way and shrinks the prostate. This shrinkage is a slow process and it typically takes three to six months to have an effect. It has almost no side effects except that it can lower a man's sex drive or libido. Some herbal medicines are thought to be beneficial for prostate enlargement though it is best to talk to us before you start taking anything at all.

Similarly, to TURBT for bladder cancer, TURP or Transurethral Resection of Prostate is the name for the operation where a surgeon looks inside the prostate and the bladder with a telescope and cuts out the inner portion of the prostate. This can be done with different energy sources and makes it easier to pass urine.