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Prostate Problems and Enlargement

Most men, if they live long enough, will develop benign prostatic hyperplasia, or an enlarged prostate. In fact, nearly 90 percent of all men show signs of prostate enlargement by age 80. As the prostate gland grows, it can put pressure on the urethra (the tube connected to the bladder that transports urine from the body), causing urinary and bladder problems.

Symptoms

Few than half the men with an enlarged prostate have symptoms, which include:

  • Dribbling at the end of urinating
  • Inability to urinate
  • Incomplete emptying of the bladder
  • Incontinence
  • Straining to urinate
  • Sudden urge to urinate
  • Painful or bloody urination

Causes

The actual cause of benign prostatic hyperplasia is unknown. Other than normal functioning testicles and age, there are no other known risk factors. Men who have had their testicles removed (e.g., because of testicular cancer) don't develop an enlarged prostate.

Diagnosis

  • Digital rectal exam to feel the size of the prostate
  • Urine flow rate test
  • Post-void residual test to see how much urine is left in the bladder after urinating
  • Tests to measure pressure in the bladder

Treatment

Treatment for an enlarged prostate depends on the symptoms and can include:

  • Medication - blood pressure medications to relax the muscles of the bladder neck and prostate; finasteride (Propecia, Proscar) to decrease the level of hormones produced by the prostate, reduce its size, and increase urine flow
  • Antibiotics to treat prostate inflammation (prostatitis)
  • Surgery-removal of the entire prostate may be recommended if the patient is experiencing incontinence, recurrent blood in the urine, urinary retention, recurrent infection, or kidney failure

Contact Information

Beth Israel Deaconess Hospital-Needham
148 Chestnut Street
Needham, MA 02492
781-453-3000