Prostate Enlargement

About Prostate Enlargement

Benign prostatic hyperplasia BPH is non cancerous enlargement of the prostate gland, affecting approximately 50 percent of men over 50 and 80 percent over 80. The prostate surrounds the urethra, and enlargement causes lower urinary tract symptoms LUTS. Symptoms include weak urine stream, difficulty starting urination hesitancy, stopping and starting during urination, dribbling after urination, frequent urination frequency, waking at night to urinate nocturia, urgent need to urinate urgency, and sensation of incomplete bladder emptying. Complications include acute urinary retention requiring catheterization, urinary tract infections, bladder stones, and kidney damage. BPH is driven by dihydrotestosterone DHT, derived from testosterone by 5 alpha reductase. Diagnosis involves history, digital rectal examination DRE, PSA blood testing in some cases after discussion of its benefits and limitations, urinalysis to rule out infection, and sometimes ultrasound to measure post void residual and prostate volume. The IPSS International Prostate Symptom Score quantifies symptoms. Treatment depends on symptom severity. Mild symptoms may be monitored. Alpha blockers tamsulosin Flomax, terazosin, alfuzosin relax prostate smooth muscle, providing quick relief. 5 alpha reductase inhibitors finasteride, dutasteride shrink the prostate over months. Combination therapy alpha blocker plus 5 ARI is most effective for enlarged prostates. The PDE5 inhibitor tadalafil can also treat BPH symptoms. Surgical options TURP transurethral resection, laser enucleation HoLEP, UroLift, Rezum steam therapy are used when medications are insufficient. Being unable to pass urine at all acute urinary retention is painful and needs emergency medical care.