Prostate, enlarged
What is an enlarged prostate?
As you get older, your prostate can get bigger. When this happens, doctors call it benign prostatic hyperplasia, or BPH. This condition is not cancer, and it isn't usually a serious health problem. But it can cause troublesome symptoms, such as having to get up at night to urinate.
If you can cope with the symptoms of an enlarged prostate, you may not need any treatment. But even if your symptoms are mild,
it's important to get them checked out by your doctor to make sure that you don't have a more serious condition. And if you do need help for BPH, your doctor can provide treatments
to help your symptoms.
Most men find it difficult to talk to their doctors about prostate problems. But don't be embarrassed. Your doctor will have
helped lots of men with your symptoms.
- Having an enlarged prostate is common, especially among older men.
- BPH isn't serious, but the symptoms can be similar to those of more serious conditions. So it's important to get checked out by a doctor.
- BPH is often slow to develop, and it doesn't always get worse. Your doctor may try different treatments to work out which one is best for you.
- A wait-and-see approach (called watchful waiting) is becoming more widely used, and traditional surgery for BPH is becoming less common. (This operation is called transurethral resection of the prostate, or TURP.)
- Drugs, herbal treatments and surgery can help your symptoms.
- If you do opt for surgery, there are several new operations that are simpler to perform than a transurethral resection of
the prostate (TURP). For many of these new procedures, you don't need a
general anesthetic
You may have a type of medication called a general anesthetic when you have surgery. It's given to make you unconscious so you don't feel pain.general anesthetic to make you sleep during the operation. - It's important to discuss the benefits and possible harms of each treatment with your doctor.
Only men have a prostate gland. It's a small, solid gland about the size of a chestnut. It helps make the milky fluid that
comes out of your penis when you have an orgasm. Glands make substances that are used somewhere else in your body. The fluid from your prostate helps keep your sperm healthy and
also helps them swim freely.
- Your prostate lies at the base of your bladder, the sac that is made of muscle and holds your urine. You can think of the prostate as a small fist resting against a bag of water.
- The front of your prostate is wrapped around your urethra, the tube that runs down from your bladder and through your penis. The urethra carries urine and semen out of your body. (Semen is the name given to your sperm and the fluid they are carried in.) Any change in the size or shape of your prostate can pinch this tube, making it difficult for you to urinate.
- The back of your prostate presses against your
rectum
The rectum is the last six to eight inches of the large intestine, ending with the anus (where you empty your bowels).rectum. This is why your doctor examines your rectum if there's a problem with your prostate. He or she can feel the gland through your rectum wall. - The two bundles of nerves that control your erections run on either side of your prostate. Because these nerves are so close to your prostate, they can be damaged by surgery on the gland.
- Your prostate is also linked to your testicles. These are the two organs that make your sperm. They lie in a pouch of skin on either side of your penis. Your sperm are
carried by tubes that run from your testicles and through your prostate into your urethra. Your prostate adds its fluid to
the sperm when they reach your urethra.
Source:
Carroll PR, Lee KL, Fuks ZY, et al.
Cancer of the prostate.
In: DeVita VT, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 6th edition. Lippincott, Williams and Wilkins, Philadelphia, U.S.A.; 2001.
1
The prostate (in red) lies beneath your bladder.
It's normal for the prostate to grow as boys approach puberty (the time when their sex organs mature). At this time, their bodies start to produce more male sex
hormones, and it's these hormones that cause the prostate to grow.
hormones
Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone estrogen is made in a woman's ovaries. Estrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone estrogen is made in a woman's ovaries. Estrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
Hormones are chemicals produced by one part of the body that travel through the bloodstream and have an effect on another
part. In men, the sex hormones are known as androgens, and the main one is testosterone. Testosterone has two effects on your prostate: it makes your prostate grow at puberty, and it also helps your prostate make
fluid to carry your sperm.
Your prostate reaches its adult size by around the time you're 20. Then, at around age 50, it starts growing again in some
men.
2 Doctors aren't sure why this is, but it's probably linked to hormone changes. One theory is that, as you get older, the cells
in your prostate respond more to the androgens in your blood and this causes the cells to grow.
3
Source:
Guyton AC, Hall JE.
Reproductive and hormonal functions of the male.
In: Textbook of Medical Physiology. 10th edition. WB Saunders, Philadelphia, U.S.A.; 2001.
Guyton AC, Hall JE.
Reproductive and hormonal functions of the male.
In: Textbook of Medical Physiology. 10th edition. WB Saunders, Philadelphia, U.S.A.; 2001.
Source:
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
When your prostate starts growing again as you get older, this condition is called benign prostatic hyperplasia, or BPH. Benign means that the condition isn't cancer. Hyperplasia means normal cells are multiplying more quickly than usual. Even though this condition isn't cancer, it may lead to troublesome
symptoms in the way your body gets rid of urine. For example, you may have to urinate often and urgently, or you may have
to strain to urinate. To read more, see What are the symptoms of an enlarged prostate?
A large prostate is about the size of an apple, and a very large one could be as big as a grapefruit.
Doctors used to think that the symptoms of BPH were caused simply by an enlarged prostate pinching or pressing on the
urethra and restricting the flow of urine from the body. Although you're more likely to have trouble urinating if your prostate is
large, BPH is not that simple.
urethra
Your urethra is the tube that carries urine from your bladder out of your body. In a man, the urethra runs through the inside of the penis. In a woman, the urethra is shorter, and opens onto the top of the vagina.
Your urethra is the tube that carries urine from your bladder out of your body. In a man, the urethra runs through the inside of the penis. In a woman, the urethra is shorter, and opens onto the top of the vagina.
Some men with a large prostate have no problems urinating, and some men with a relatively small prostate do.
3
Source:
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
Doctors now know that some symptoms can be caused by changes in your
bladder that are triggered by changes in your prostate.
3 For example, the wall of your bladder may become thick and irritable. This can make your bladder contract (get smaller) when
it contains only small amounts of urine. (Normally your bladder contracts when it is full of urine.) This makes you feel like
you need to urinate more often. Eventually your bladder may become so weak that it can't empty itself. If urine remains in
your bladder, it can cause infections such as
cystitis.
4 To read more, see Complications of an enlarged prostate.
bladder
Your bladder is the hollow organ at the top of your pelvis that stores urine. It is similar to a balloon, only with stronger walls. It fills up with urine until you go to the bathroom.
Your bladder is the hollow organ at the top of your pelvis that stores urine. It is similar to a balloon, only with stronger walls. It fills up with urine until you go to the bathroom.
Source:
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
McConnell, J
Epidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.
In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
cystitis
Cystitis is an inflammation of the wall of your bladder. It can make you feel as if you want to urinate all the time. The term is often used to describe a urinary tract infection that involves your lower urinary tract (your bladder and urethra) but not your kidneys. These infections are most often caused by bacteria.
Cystitis is an inflammation of the wall of your bladder. It can make you feel as if you want to urinate all the time. The term is often used to describe a urinary tract infection that involves your lower urinary tract (your bladder and urethra) but not your kidneys. These infections are most often caused by bacteria.
Source:
Medina JJ, Parra RO, Moore RG.
Benign prostatic hyperplasia (the aging prostate).
Medical Clinics of North America. 1999; 83: 1213-1229.
Medina JJ, Parra RO, Moore RG.
Benign prostatic hyperplasia (the aging prostate).
Medical Clinics of North America. 1999; 83: 1213-1229.
The good news is that lots of treatments are available for BPH, so don't put off seeing your doctor. Also, by getting treatment for BPH as soon as possible, you may prevent future problems
with your bladder. Remember that doctors see men with these symptoms every day, so you shouldn't feel embarrassed talking
with your doctor about your condition.
There are some things that make it more likely that you will get an enlarged prostate. These things are called risk factors.
- Your age: Your chances of getting an enlarged prostate increase as you get older.
Source:
Medina JJ, Parra RO, Moore RG.
Benign prostatic hyperplasia (the aging prostate).
Medical Clinics of North America. 1999; 83: 1213-1229.
4 - Your family history: Enlarged prostates seem to run in some families. If your father or brother has had BPH, then you are at greater risk of getting it.
- Your race: Black men seem to have enlarged prostates that need surgery more often than white men do. And Asian men seem to
be less likely than white men to need surgery. These trends need more study, and may be due to things such as diet.
Source:
Sideny S, Quesenberry CP, Sadler MC, et al
Incidence of surgically treated benign prostatic hypertrophy and of prostate cancer among black and white mutliphasic examinees in a prepaid health care plan.
American Journal of Epidemiology. 1991; 134: 825-829.
5Source:
Platz EA, Kawachi I, Rimm EB, et al.
Race, ethnicity and benign prostatic hyperplasia in the health professionals follow-up study.
Journal of Urology. 2000; 163: 490.
6Source:
Lagiou P, Wuu J, Trichopoulou A, et al.
Diet and benign prostatic hyperplasia: a study in Greece.
Urology. 1999; 44: 688.
7
Sources for the information on this page:
- Carroll PR, Lee KL, Fuks ZY, et al.Cancer of the prostate.In: DeVita VT, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 6th edition. Lippincott, Williams and Wilkins, Philadelphia, U.S.A.; 2001.
- Guyton AC, Hall JE.Reproductive and hormonal functions of the male.In: Textbook of Medical Physiology. 10th edition. WB Saunders, Philadelphia, U.S.A.; 2001.
- McConnell, JEpidemiology, etiology, pathophysiology, and diagnosis of benign prostatic hyperplasia.In: Campbell MF, Walsh PC, Retik AB. Campbell's Urology. 8th edition. WB Saunders, New York, U.S.A.; 2002.
- Medina JJ, Parra RO, Moore RG.Benign prostatic hyperplasia (the aging prostate).Medical Clinics of North America. 1999; 83: 1213-1229.
- Sideny S, Quesenberry CP, Sadler MC, et alIncidence of surgically treated benign prostatic hypertrophy and of prostate cancer among black and white mutliphasic examinees in a prepaid health care plan.American Journal of Epidemiology. 1991; 134: 825-829.
- Platz EA, Kawachi I, Rimm EB, et al.Race, ethnicity and benign prostatic hyperplasia in the health professionals follow-up study.Journal of Urology. 2000; 163: 490.
- Lagiou P, Wuu J, Trichopoulou A, et al.Diet and benign prostatic hyperplasia: a study in Greece.Urology. 1999; 44: 688.
This information was last updated on Oct 13, 2008
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
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