The prostate, a small gland that produces fluid for semen, is in an ideal position to cause trouble. The gland wraps snugly around the urethra, the tube that carries urine from the bladder. It’s a tight squeeze — and it only gets tighter as men grow older.
As men age, the prostate inevitably grows, putting more and more pressure on the urethra. For some men, this growth is too slow to ever cause any symptoms. But for most, it’s only a matter of time before trouble sets in. According to the National Institutes of Health, more than half of all men in their 60s and 90 percent of men in their 80s have symptoms of an enlarged prostate, also called benign prostatic hyperplasia, benign prostatic hypertrophy, or simply BPH.
For most men, an enlarged prostate is little more than a nuisance. But in severe cases, it can completely block the flow of urine and create a medical emergency. Whether a man’s condition is mild or extreme, he has many options for relief.
What are the symptoms of an enlarged prostate?
As the prostate begins to squeeze the urethra, emptying the bladder becomes more and more difficult. Common symptoms include the following:
- Frequent urination, especially at night
- A weak urine stream
- Topping and starting during urination
- Leaking, dribbling
- A feeling that the bladder is never completely empty
How is an enlarged prostate diagnosed?
If you’re a man over 40 with the above symptoms, your doctor will immediately suspect an enlarged prostate. However, it’s not the only possible diagnosis. The doctor will probably want to run a few other simple tests to rule out other conditions. A urine test can check for infection. A prostate-specific antigen (PSA) blood test combined with a digital rectal exam may help rule out prostate cancer. The digital rectal exam will also allow the doctor to feel the prostate and gauge its size. Be sure to discuss these tests with your doctor if he or she recommends them in order to weigh their potential benefits or risks.
In some cases, severe symptoms appear even though the prostate is only slightly larger than normal. For this reason, your doctor may not notice any unusual swelling during the digital rectal exam. If there’s doubt about the cause of symptoms, the doctor may take a closer look by inserting a cystoscope — a narrow tube equipped with a tiny camera — into the urethra. You may also be asked to urinate into a device that measures urine flow.
What can you do to ease your symptoms?
First things first: If you have symptoms of an enlarged prostate, you should see your doctor. Remember, there’s a chance that your symptoms may signal something more serious. Once your doctor diagnoses your enlarged prostate, there are many things you can do to help yourself. If your symptoms are mild, these self-care steps, adapted from Mayo Clinic guidelines, may be the only treatment you need:
- You can cut down on nighttime trips to the bathroom by avoiding drinking beverages after 7 pm.
- Try to urinate when you first feel the urge. Every time you urinate, make an extra effort to empty the bladder completely.
- Go easy on alcohol and caffeine, which increase the need to urinate.
- Avoid over-the-counter cold remedies that contain antihistamines and decongestants. Antihistamines can impair the muscles that control the opening to the bladder and the bladder itself. Decongestants can tighten muscles around the bladder, making it difficult to empty. If the cold medication contains both, it may be nearly impossible to urinate.
- Stay active. Regular exercise can help keep urine from pooling in your bladder.
- Keep warm. When your body is cold, your bladder is more likely to retain extra urine.
What can your doctor do to treat your enlarged prostate?
In recent years, the Food and Drug Administration has approved several drugs for the treatment of enlarged prostates. One class of drugs, known as alpha-blockers, relaxes muscles at your bladder neck and makes it easier to