An enlarged prostate is a common, non-cancerous condition affecting men as they age.
The prostate naturally grows larger as men age. This can cause trouble with urination.
An enlarged prostate (also called benign prostatic hyperplasia, or BPH) often results in symptoms such as frequent urination, a weak urinary stream, difficulty starting urination, and the feeling that the bladder is not completely empty.
BPH affects millions of men, particularly those over the age of 50. Understanding the condition empowers you to seek timely medical guidance.
Urologists at WashU Medicine
Urologists at WashU Medicine see patients at Barnes-Jewish Hospital, one of the top hospitals in the nation, as well as convenient locations across the region.
What is the prostate?
The prostate is a small gland in the male reproductive system. It is located below the bladder. The prostate surrounds the urethra, which is the tube that carries urine and semen out of the body.
The prostate produces fluid that mixes with semen, making sperm healthy for pregnancy.
As men age, their prostate gets bigger. This can lead to problems like trouble urinating.
Risk factors
Several factors contribute to the likelihood of developing BPH:
- Age: The risk of an enlarged prostate increases with age.
- Family history: Men with a family history of prostate problems are more likely to develop BPH.
- Lifestyle and diet: A diet high in red meat and fat, coupled with a sedentary lifestyle, may make symptoms worse.
Screening and diagnosis
Regular screening plays a crucial role in early detection and management.
Common diagnostic methods include:
- Digital rectal exam (DRE): Your doctor might use their finger to check the size of your prostate.
- Prostate-specific antigen (PSA) test: This blood test checks for elevated PSA levels, which may indicate an enlarged prostate. This test is also used to check for prostate cancer signs.
- Ultrasound and urine flow studies: These will help evaluate the prostate’s impact on the urinary system.
Treatment options
There are multiple treatments for an enlarged prostate. Deciding on which treatment is best for you depends on your health and goals.
Urologists at WashU Medicine have the knowledge and expertise to ehlp you find a BPH treatment that works for you.
Medications
Medication is often the first line of treatment for managing symptoms, including:
- Alpha blockers: These drugs help relax the muscles of the bladder neck and prostate.
- 5-Alpha reductase inhibitors: These reduce prostate size by hormonal effects.
Minimally invasive procedures
For men who do not respond to medication, there are procedures that can help treat an enlarged prostate. These include:
Waterjet therapy
One of the latest advances in BPH treatment uses a heat-free waterjet to remove excess prostate tissue. This treatment combines ultrasound imaging with robotic precision to provide long-lasting BPH relief.
Waterjet therapy is a resective procedure, which means that the prostate tissue causing symptoms is surgically removed. No incision is made in the abdomen, as the prostate is reached through the urethra.
Waterjet therapy is performed in a hospital with anesthesia. The procedure typically takes an hour and may involve an overnight stay.
Laser treatment
Minimally invasive laser therapy uses a high-powered laser to remove overgrown prostate cells. This treatment uses a thin device inserted into the urethra to vaporize excess prostate tissue that is blocking the bladder.
Doctors usually perform this procedure in an operating room with anesthesia. This procedure does not require an incision, and there is typically no overnight hospital stay.
Permanent implants
The prostatic urethral lift is a minimally invasive procedure to treat BPH. In this procedure, your urologist inserts tiny implants through the urethra to move the enlarged prostate away from the urethra, allowing urine to flow more easily.
Instead of removing or destroying the excess prostate tissue, the treatment uses permanent implants to lift the tissue out of the way. This procedure does not use incisions. After this procedure, there is usually no overnight hospital stay.
Transurethral resection of the prostate (TURP)
Transurethral resection of the prostate (TURP) is a surgery to remove excess prostate tissue. In this procedure, your urologist inserts a wire loop, called a resectoscope, through the urethra. The wire loop delivers an electric current that trims away the extra prostate tissue.
This procedure is done in an operating room with anesthesia and typically requires 1-2 days of hospital stay.
What to expect
You and your urologist will decide on the best treatment for your goals and condition. It’s important to know what to expect from your treatment, that way you can be prepared to have the best possible results.
- Recovery after surgery: usually involves a catheter for a few days
- Gradual symptom improvement: Medications and minimally invasive methods take time to show full results
An enlarged prostate is manageable with proper knowledge and treatment.
If left untreated, an enlarged prostate can lead to urinary retention, bladder stones, and kidney damage.
Consult your health care provider for a personalized approach to managing your prostate health.
