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Enlarged Prostate & Symptoms

The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine leaves the body.
An enlarged prostate means the gland has grown bigger and happens to almost all men as they age. As the gland grows, it can press on the urethra and cause urination and bladder problems.
An enlarged prostate is called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer and does not increase the risk of prostate cancer.

Alternative Names

HPB; hypertrophy (hyperplasia) prostatic benign enlarged prostate

Causes, incidence and risk factors

No one knows the actual cause of prostate enlargement. It is believed that factors linked to aging and the testicles themselves may play a role in the growth of the gland. The men who had their testicles removed at an early age (for example, as a result of testicular cancer) do not develop BPH.

Similarly, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.
Some facts about prostate enlargement are:

  • The probability of developing enlarged prostate increases with age.
  • BPH is so common that it has said, "All men will have prostate enlargement if they live long enough."
  • A small degree of prostate enlargement is present in many men over age 40 and over 90% of men older than 80 years.
  • We have not identified risk factors other than having normally functioning testicles.

Symptoms

Less than half of men with BPH have symptoms of the enlarged prostate, which can include the following:

  • Difficulty starting to urinate
  • Weak urine stream
  • Urinary dribbling
  • Straining to urinate
  • Strong and sudden urge to urinate
  • Incomplete emptying of the bladder
  • Needing to urinate 2 or more times per night
  • Urinary retention (inability to urinate)
  • Incontinence
  • Painful urination or bloody urine (this may indicate infection)

Exams and Tests

After taking a complete medical history, your doctor will perform a rectal examination to palpate the prostate gland; Also, you can perform the following tests:

  • Urine flow rate
  • Analysis of Post-void residual urine to see how much urine is left in the bladder after urination
  • Pressure flow studies to measure the pressure in the bladder during urination
  • A PIV (X-ray study) to confirm BPH or look for blockage
  • Urinalysis to check for blood or infection
  • Urine culture to check for infection
  • ( PSA ) A blood test for prostate specific antigen (PSA) for prostate cancer
  • Cystoscopy

Additionally, you may be asked to complete a form to evaluate the severity of symptoms and their impact on everyday life. The score of this assessment can be compared to past records to determine if the condition is worsening.

 

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