Healthy Living

Enlarged prostate gland; How dangerous, How common?

Enlarged prostate gland; How dangerous, How common?

If your symptoms of an enlarged prostate gland (benign prostatic hyperplasia, or BPH) are mild and not particularly bothersome, your doctor will recommend a conservative approach called watchful waiting. BPH tends to get worse over time, but it's safe to just keep an eye on it until it becomes bothersome enough to justify further treatment. If the symptoms are getting worse, you and your doctor might then discuss further options, like starting on medication. You might consider surgery if you are beginning to have serious complications like recurrent urinary retention.

In follow-up visits, your primary care doctor or urologist will measure your symptoms, perform a physical exam (including a digital rectal exam), and run lab tests. You'll probably visit the doctor every year or every six months, depending on your symptoms. Tests likely will include a PSA measurement, as well as a urinalysis to look for blood and any sign of infection.

Lifestyle changes

Watchful waiting doesn't mean "wait and do nothing," however. Between visits to the doctor, you'll be encouraged to make simple changes in behavior that can help to ease urinary symptoms whether you choose treatment or not. Your doctor will recommend careful management of what, when, and how much you drink and changes in urination behavior. Changes in your regular medications also may help.

Fluid management:

  • Avoid drinking fluids in the evening.
  • Minimize consumption of carbonated and caffeinated drinks.
  • Reduce or eliminate alcohol.
  • Drink only when you feel thirsty.
  • Don't drink more than an 8-ounce cup at a time.
  • Sip beverages slowly. The faster your bladder fills, the more likely you are to feel urgency.
  • Avoid drinking a lot of fluids before going out in public or starting a trip.

Behavior changes:

  • Urinate when you first get the urge.
  • Go to the bathroom on a timed schedule, even if you don't feel a need to go.
  • When you go to the bathroom, take the time to empty your bladder completely. This will reduce the need for subsequent trips to the toilet.

Some prescription and over-the-counter drugs, such as antihistamines and decongestants, may affect urination. You may be able to reduce the effects by changing the dosages, changing when you take them, or switching to medications that cause fewer urinary problems.

Aim for a healthy eating pattern

In a nutshell, here's what experts recommend:

  1. Eat at least five servings of fruits and vegetables every day. Go for those with deep, bright color.
  2. Choose whole-grain bread instead of white bread and choose whole-grain pasta and cereals.
  3. Limit your consumption of red meat, including beef, pork, lamb, and goat, and processed meats, such as bologna and hot dogs. Fish, skinless poultry, beans, and eggs are healthier sources of protein.
  4. Choose healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Avoid partially hydrogenated fats (trans fats), which are in many fast foods and packaged foods.
  5. Avoid sugar-sweetened drinks, such as sodas and many fruit juices. Eat sweets as an occasional treat.
  6. Cut down on salt. Choose foods low in sodium by reading and comparing food labels. Limit the use of canned, processed, and frozen foods.
  7. Watch portion sizes. Eat slowly and stop eating when you are full.

 

Stay active to support prostate health

In addition to eating a healthy diet, you should stay active. Regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer. And although relatively few studies have directly assessed the impact of exercise on prostate health, those that have been done have concluded, for the most part, that exercise is beneficial. For example:

  1. They found an inverse relationship between physical activity and BPH symptoms. Simply put, men who were more physically active were less likely to suffer from BPH. Even low- to moderate-intensity physical activity, such as walking regularly at a moderate pace, yielded benefits.
  2. They found that men who ran for an hour and a half or did three hours of rigorous outdoor work per week were 20% less likely to develop ED than those who didn't exercise at all. More physical activity conferred a greater benefit. Interestingly, regardless of the level of exercise, men who were overweight or obese had a greater risk of ED than men with an ideal body mass index, or BMI.
  3. Aerobic exercise, which included brisk walking, or non-aerobic exercise, which included leg lifts, sit-ups, and stretching. At the end of the trial, men in both groups felt better, but those in the aerobic exercise group experienced significantly less discomfort, anxiety and depression, and improved quality of life

Common signs and symptoms of BPH include:

  • Frequent or urgent need to urinate
  • Increased frequency of urination at night (nocturia)
  • Difficulty starting urination
  • Weak urine stream or a stream that stops and starts
  • Dribbling at the end of urination
  • Inability to completely empty the bladder

Less common signs and symptoms include:

  • Urinary tract infection
  • Inability to urinate
  • Blood in the urine

The size of your prostate doesn't necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

In some men, symptoms eventually stabilize and might even improve over time.

Other possible causes of urinary symptoms

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

  • Urinary tract infection
  • Inflammation of the prostate (prostatitis)
  • Narrowing of the urethra (urethral stricture)
  • Scarring in the bladder neck as a result of previous surgery
  • Bladder or kidney stones
  • Problems with nerves that control the bladder
  • Cancer of the prostate or bladder

When to see a doctor

If you're having urinary problems, discuss them with your doctor. Even if you don't find urinary symptoms bothersome, it's important to identify or rule out any underlying causes. Untreated, urinary problems might lead to obstruction of the urinary tract.

If you're unable to pass any urine, seek immediate medical attention.

Causes

The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

It isn't entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.

Risk factors

Risk factors for prostate gland enlargement include:

  • Prostate gland enlargement rarely causes signs and symptoms in men younger than age 40. About one-third of men experience moderate to severe symptoms by age 60, and about half do so by age 80.
  • Family history.Having a blood relative, such as a father or a brother, with prostate problems means you're more likely to have problems.
  • Diabetes and heart disease.Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.
  • Obesity increases the risk of BPH, while exercise can lower your risk.

Complications

Complications of an enlarged prostate can include:

  • Sudden inability to urinate (urinary retention).You might need to have a tube (catheter) inserted into your bladder to drain the urine. Some men with an enlarged prostate need surgery to relieve urinary retention.
  • Urinary tract infections (UTIs).Inability to fully empty the bladder can increase the risk of infection in your urinary tract. If UTIs occur frequently, you might need surgery to remove part of the prostate.
  • Bladder stones.These are generally caused by an inability to completely empty the bladder. Bladder stones can cause infection, bladder irritation, blood in the urine and obstruction of urine flow.
  • Bladder damage.A bladder that hasn't emptied completely can stretch and weaken over time. As a result, the muscular wall of the bladder no longer contracts properly, making it harder to fully empty your bladder.
  • Kidney damage.Pressure in the bladder from urinary retention can directly damage the kidneys or allow bladder infections to reach the kidneys.

Most men with an enlarged prostate don't develop these complications. However, acute urinary retention and kidney damage can be serious health threats.

Having an enlarged prostate is not believed to increase your risk of developing prostate cancer.

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