Benign (noncancerous) enlargement of the prostate, known as benign prostatic hyperplasia, or BPH, is the most common prostate problem in men. Almost all men will develop some enlargement of the prostate as they age.
Overall, the number of men with BPH increases progressively with age. By age 60, 50% of men will have some signs of BPH. By age 85, 90% of men will have signs of the condition. About half of these men will develop symptoms that need to be treated.
Based on research to date, having BPH does not seem to increase the risk of developing prostate cancer. However, BPH and prostate cancer have similar symptoms, and a man who has BPH may have undetected cancer at the same time.
To help detect prostate cancer in its early stages, the American Urological Association and the American Cancer Society recommend a screening every year for men ages 50 to 70. They further recommend that men who are at high risk – such as African-American men and men with a family history of prostate cancer – begin screening at about age 40. Screening tests for prostate cancer include a blood test for a substance called prostate-specific antigen (PSA) and the digital rectal exam (DRE).
Since the prostate gland surrounds the urethra (the tube that carries urine outside the body), it is easy to understand that enlargement of the prostate can lead to blockage of the tube. Therefore, you may develop:
The enlargement of the prostate can lead to blockage of the urethra.
Your doctor will look at your medical history and give you a complete physical. Your doctor will perform a digital rectal examination by inserting a gloved, lubricated finger into your rectum to feel the prostate. Because the prostate gland is in front of the rectum, it is relatively easy for the doctor to feel much of the gland. This enables him or her to estimate the size of the prostate and to detect any hard areas that could be cancer.
Several studies may be performed to help diagnose your condition:
Patients with mild symptoms may not require treatment other than continued observation to make sure their condition doesn't get worse. This approach is sometimes called "watchful waiting" or surveillance. There are a number of treatment options available if your symptoms are severe:
Treatments for BPH include:
Proscar was one of the first drugs used to treat BPH. It works by slowing the production of the hormone dihydrotestosterone (DHT), which affects the growth of the prostate gland. Proscar appears to be most beneficial for men with larger prostates.
Drugs that relax the muscle in the prostate (to reduce the tension on the urine tube) are more commonly used. These include Hytrin®, Cardura®, and Flomax®. The most common side effects are light-headedness and weakness.
A number of surgical procedures have been used to remove the prostate tissue blocking the flow of urine.
Another, less complicated procedure is transurethral incision of the prostate (TUIP). Instead of removing tissue, as with TURP, this approach involves widening the urethra by making several small cuts in the bladder neck (area where the urethra and bladder join), as well as in the prostate gland itself. This relieves some of the pressure on the urethra and improves urine flow.
Minimally invasive treatments
New treatments have been developed in recent years that can effectively reduce the size of the prostate and relieve urinary blockage, but are less invasive and damaging to healthy tissue than is surgery. In general, minimally invasive procedures require less time in the hospital, result in fewer side effects, are less costly, and allow for quicker recovery. The most common side effects reported with these treatments include urinary frequency and irritation while the prostate is healing. However, many of these techniques are new, and little is known about the long-term effectiveness and complications of these procedures.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 03/01/2016