Medically ReviewedDr. Manish DubeyUrologist Medically ReviewedDr. Manish DubeyDr. Manish Dubey, Director and Consultant Urologist at MITR Hospital, Kharghar, has 20+ years in onco-urology and robotic and laparoscopic urology.
View doctor profileThe prostate is a small gland in the male reproductive system located below the bladder and surrounding the urethra. As men grow older, their prostate typically grows bigger, leading to a condition called an enlarged prostate or BPH.
Men often overlook early enlarged prostate symptoms because they may seem minor at first. But catching these signs early can help avoid complications and boost quality of life.
Key Takeaways
- An enlarged prostate, medically known as Benign Prostatic Hyperplasia (BPH), is not cancer. It does not increase the risk of developing prostate cancer.
- The most common early symptoms of an enlarged prostate involve changes in urinary frequency, urine flow, and the feeling of incomplete bladder emptying.
- Waking up multiple times at night to pee is often the first sign of an enlarged prostate. Nocturia can start bothering men a lot, but it’s easy to spot early on.
- Age and family history mainly raise the risk, though. By age 60, approximately half of men have evidence of prostate enlargement.
- If untreated, severe cases might cause total urinary blockages, painful bladder stones, or serious kidney damage.
- There are lots of treatment options out there for an enlarged prostate, too, like taking simple daily pills or getting quick, minimally invasive surgeries.
What is an Enlarged Prostate?
The prostate is a tiny reproductive gland in men, roughly the size and shape of a walnut. It lies beneath the bladder and surrounds the upper part of the urethra. The urethra is a thin tube that gets rid of urine and semen from the body through the penis. The prostate gland’s main role is making fluid that nourishes sperm and forms semen. This fluid plays an important role in nourishing and transporting sperm.
As the prostate enlarges, the surrounding tissues limit its outward expansion. It can compress the urethra, restricting the flow of urine.
- The condition is non-cancerous, which is what the term “benign” means.
- The prostatic part tells us it’s about the prostate gland.
- Hyperplasia means there is an increase in the number of normal cells within the prostate gland.
- Although it isn’t cancer, the extra growth puts pressure on your urinary tract.
This can seriously impact how well you enjoy your day-to-day life.
Why the Prostate Enlarges
The exact cause of prostate enlargement is not fully understood, but aging and hormonal changes are believed to play major roles.
- Changing Hormones: As men age, their testosterone levels drop while estrogen levels increase. This shift can trigger prostate growth, leading to enlargement. Therefore, hormonal changes are thought to contribute significantly to prostate enlargement.
- DHT Build-Up: Dihydrotestosterone (DHT), a hormone derived from testosterone, can accumulate in prostate tissue over time. Increased exposure to DHT may stimulate continued growth of prostate cells, leading to enlargement.
- Cell Growth Imbalance: In younger men, old prostate cells die off and get replaced in a balanced way. With aging, the balance between cell growth and cell death may be disrupted, resulting in gradual enlargement of the prostate tissue.
Common Early Enlarged Prostate Symptoms
The growth of the prostate gland is usually gradual, so symptoms typically develop slowly over time rather than appearing suddenly. Instead, early symptoms of enlarged prostate develop subtly over months or even years. Most men dismiss these changes as being simply a part of aging.
Most symptoms of an enlarged prostate are classified as either voiding (obstructive) symptoms or storage (irritative) symptoms. Obstructive symptoms affect urine flow, while irritative symptoms involve increased bladder activity. That is basically all you need to know.
A Weak or Hesitant Urine Stream
You may notice a delay in starting urination, even when you feel the urge to urinate. When urination begins, the urine stream may be weaker than usual.
Intermittent stream
Urine flow may stop during urination and start again later on or not in uniform flow. Some men may also experience post-void dribbling, where urine leaks after finishing urination.
Frequent Daytime Urination
You are finding yourself rushing to the bathroom much more than before. Urinating more than eight times during waking hours may indicate that the enlarged prostate is affecting bladder function.
Waking Up at Night (Nocturia)
It is almost always the most disruptive initial sign. Waking up at least 2, 3, or more times every night to urinate disrupts your sleep cycle, leaving you extremely tired during the day.
Sudden, Uncontrollable Urgency
You will find that you have an urgent need to urinate which means that once the urge for urination starts, it becomes difficult to control it. This occurs because the bladder must work harder to overcome the obstruction caused by the enlarged prostate. As a result, the bladder becomes highly irritable.
Feeling Like Your Bladder is Full
Once you’ve gone to the bathroom, you may still feel as though you aren’t done. There will always be some amount of urine left in the bladder even after voiding. The desire to urinate strikes again 10 to 15 minutes later, even though you have just finished.
Risk Factors for Prostate Enlargement
Any man can have an enlarged prostate, but some risk factors will greatly increase your chance.
- Age: Age is the most important factor here. While you won’t experience any symptoms until you’re over 40, the chances become greater as you get older.
- Family History: A family history of prostate enlargement, particularly in a father or brother, may increase the risk of developing BPH.
- Obesity and Inactivity: Obesity, particularly excess abdominal fat, and physical inactivity have been associated with an increased risk of prostate enlargement. This causes hormonal imbalances and also increases the risk of inflammation, leading to enlargement of the prostate gland.
- Type 2 Diabetes: Type 2 diabetes has been associated with an increased risk of prostate enlargement, possibly due to hormonal and metabolic changes.
- Cardiovascular Conditions: Conditions such as hypertension and cardiovascular disease have been associated with an increased risk of BPH, although the exact relationship is not fully understood.
Enlarged Prostate Treatment Options
If you have mild symptoms due to an enlarged prostate, then your urologist will advise you to undergo surveillance or watchful waiting. If symptoms begin affecting daily life, there are many successful enlarged prostate treatment options. The treatment options may be medical or surgical management. The first option is always medical management and surgical treatment may be required if medical management fails.
Prescription Medications
- Alpha Blockers: These medicines relax muscles of the prostate and bladder neck to ease urination.
- 5-Alpha Reductase Inhibitors: These medications help shrink the prostate or slow its further enlargement.
Surgical Options
In men with severe symptoms, complications, or significantly enlarged prostates, surgery may provide long-term symptom relief.
- Minimal invasive options:
- Transurethral Resection of the Prostate (TURP): TURP can be monopolar or bipolar. This is the gold standard in management of patients with enlarged prostate requiring surgery. A surgical procedure in which excess prostate tissue is removed to improve urine flow.
- Laser Enucleation of the Prostate (HoLEP): A surgical procedure using lasers to remove tissue blocking urine flow.
Other options: When above mentioned surgical options are not feasible in patients then one of the following treatment options are available and can be recommended to the patients
- Prostatic Urethral Lift (UroLift): Implants are inserted to keep the enlarged prostate tissue out of the way of the urethra.
- Water Vapor Therapy (Rezūm): A minimally invasive procedure that uses water vapor (steam) to destroy excess prostate tissue causing urinary obstruction.
Surgical Options
In men with severe symptoms, complications, or significantly enlarged prostates, surgery may provide long-term symptom relief.
- Transurethral Resection of the Prostate (TURP): A surgical procedure in which excess prostate tissue is removed to improve urine flow.
- Laser Enucleation of the Prostate (HoLEP): A surgical procedure using lasers to remove tissue blocking urine flow.
Final Recommendations
An enlarged prostate is a very common condition among aging men, and in many cases, it can be managed effectively with appropriate medical care. Most importantly, having an enlarged prostate does not mean that one has prostate cancer.
If you observe that your urine flow is weak, that you need to urinate frequently at night, and even feel a sudden urge to urinate, it would be wise not to overlook these enlarged prostate symptoms.
The treatments currently available are very effective and can help relieve symptoms and maintain good urinary health. If the symptoms continue, you should visit a doctor or urologist.
FAQs About Enlarged Prostate
An enlarged prostate, medically known as Benign Prostatic Hyperplasia (BPH), is a common, non-cancerous condition in which the prostate gland increases in size as men age.
Yes. One of the most common symptoms of an enlarged prostate is frequent urination, especially during the night. As the enlarged prostate presses against the urethra, the bladder has to work harder, leading to increased urinary frequency and urgency.
No. Men with mild enlarged prostate symptoms may only need regular monitoring and lifestyle changes. Enlarged prostate treatment is recommended when symptoms interfere with daily activities or lead to complications such as urinary retention or recurrent infections.
The best enlarged prostate treatment depends on the severity of symptoms. Mild cases may be managed with medications, while moderate to severe cases may require minimally invasive procedures or surgeries such as TURP or HoLEP.
No. Benign Prostatic Hyperplasia (BPH), or an enlarged prostate, is a non-cancerous condition. Although both conditions can cause similar urinary symptoms, having an enlarged prostate does not increase the risk of developing prostate cancer.
If left untreated, an enlarged prostate can lead to urinary retention, bladder stones, recurrent urinary tract infections, bladder damage, and, in severe cases, kidney damage. Timely enlarged prostate treatment can help prevent these complications.
Many men experience long-term relief with appropriate enlarged prostate treatment. Medications help manage symptoms, while surgical procedures such as TURP and HoLEP can provide lasting improvement by removing the excess prostate tissue causing urinary obstruction.
In most cases, enlarged prostate symptoms do not disappear on their own because the prostate usually continues to grow with age.
An enlarged prostate does not usually cause pain. However, it can lead to discomfort while urinating, difficulty emptying the bladder, or pain if complications such as a urinary tract infection or urinary retention develop. If you experience persistent pelvic pain or severe discomfort, consult a urologist promptly.
The earliest enlarged prostate symptoms usually include a weak urine stream, difficulty starting urination, frequent urination, waking up multiple times at night to urinate (nocturia), and a feeling that the bladder has not emptied completely.
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