Prostate Enlargement (Benign Prostatic Hyperplasia) - Symptoms & Causes

What is prostate enlargement (BPH)?

Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a non-cancerous swelling of the prostate gland. It is a common urological condition in men above 50 years old.

The prostate is a gland located underneath the bladder and close to the urethra, the tube that transports urine out of the penis. Only men have a prostate, as its function is to produce fluid for semen.

The prostate is normally the size of a walnut in younger men, or the size of a golf ball in older men. In men who have benign prostatic hyperplasia, the prostate becomes enlarged, swelling up to the size of a tennis ball and pressing on the urethra, thus causing urinary symptoms.

What are the symptoms of prostate enlargement (BPH)?

BPH causes symptoms of the lower urinary tract when the enlarged prostate exerts pressure on the urethra and prevents the normal flow of urine out of the bladder. With growing pressure, the bladder starts to contract even when it is not completely full, and eventually loses the ability to empty itself.

Symptoms of an enlarged prostate include:

• Slow or reduced urinary stream
• Interrupted urine flow (needing to stop and start several times)
• Difficulty or straining to start urination (hesitancy)
• More frequent need to urinate
• Waking up at night to urinate (nocturia)
• Sudden need to urinate (urgency), or sudden inability to urinate (acute retention of urine)
• Being unable to fully empty your bladder
• Feeling like your bladder is still full after urinating
• Pain while urinating or during ejaculation
• Blood in your urine

If you find you are unable to urinate at all, experience pain or chills while urinating, or notice blood in your urine, seek medical help immediately.

What causes prostate enlargement (BPH)?

It is unclear what causes BPH to develop, though hormonal changes are believed to be a trigger. As men age, testosterone levels decline while another hormone, dihydroxytestosterone (DHT), increases, leading to prostate cell growth.

Imbalance in other growth factors that control cell division and cell death may also play a role in causing BPH.

What are the risk factors for prostate enlargement (BPH)?

The risk of developing BPH increases with age. BPH is found in approximately 50% of men between the ages of 51 – 60, and up to 90% in men over 80 years old.

Other factors that may increase the risk of BPH include:

• Family history of prostate problems
• Certain medical conditions such as diabetes, heart disease or erectile dysfunction
• A sedentary or inactive lifestyle
• Being overweight (obesity)

What are the complications and related diseases of prostate enlargement (BPH)?

If the prostate becomes too large, it can cause complications such as:

• Acute urinary retention (being completely unable to pass urine). Should this happen, you will need to have a catheter inserted into your bladder to drain the urine.
• Urinary tract infection (UTI). If you are unable to completely empty your bladder, you run the risk of getting a UTI as stagnant urine can breed bacteria.
• Bladder stones. Bladder stones may develop after recurrent UTIs, leading to further complications such as bladder infection and obstructed urine flow.
• Bladder damage. BPH can cause the bladder muscles to stretch and weaken over time.
• Kidney (renal) failure. Long-term pressure from retaining urine in the bladder may damage the kidneys permanently and lead to kidney failure. Those with kidney failure will require dialysis for life.

How do you prevent prostate enlargement (BPH)?

There is no specific way to prevent BPH, but you may be able to reduce your risk by:

• Eating a well-balanced diet that is rich in fruits and vegetables
• Limiting alcohol intake
• Leading an active lifestyle
• Maintaining a healthy weight.