What Are The Signs And Symptoms Of An Enlarged Prostate
An enlarged prostate is the most common cause of urinary problems in men as they get older. Possible symptoms include:
- a weak flow when you urinate
- a feeling that your bladder hasnt emptied properly
- difficulty starting to urinate
- dribbling urine after you finish urinating
- needing to urinate more often, especially at night
- a sudden urge to urinate you may sometimes leak before you get to the toilet.
You may not get all of these symptoms, and some men with an enlarged prostate dont get any symptoms at all. These symptoms can also be caused by other things, such as cold weather, anxiety, other health problems, lifestyle factors, and some medicines. Blood in your urine may be a symptom of an enlarged prostate. But this is rare and is usually caused by something else.
If you have any of the symptoms above, you should visit your GP to find out what may be causing them.
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What Is Enlarged Prostate
Enlarged prostate refers to the state in which the prostate is enlarged but not cancerous.
Hormonal changes and cell growth resulting from the aging process may cause the prostate to swell, often impinging upon and compressing the urethra. This causes the bladder walls to become thicker and can prevent the bladder from emptying completely.
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What Are The Symptoms Of Enlarged Prostate
When the prostate becomes enlarged, it can block the urethra and impair bladder function. Symptoms that may indicate this is happening include:
- Urinating many times a day and being unable to hold off urination
- Problems starting a urine stream or a weak or interrupted stream, followed by dribbling at the end
- Waking at night to urinate and accidental loss of urine
How Is Enlarged Prostate Diagnosed
The first step is a standard physical exam which often involves a urine analysis and a digital rectal exam, which involves a doctor inserting a finger into the rectum. The physician will assess the size and contour of the prostate and determine if any nodules are present, which may suggest the presence of prostate cancer.
The physician may also assess for tenderness, which can be found when the prostate is inflamed. Tests may be done in the office to assess strength of urine flow or to check for residual urine in the bladder.
Next, doctors may run one or several tests to make an accurate diagnosis. These can include a PSA blood test, urodynamic tests , cystoscopy and transrectal ultrasound .
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How To Tell If Your Prostate Is Enlarged
The prostate gland is an integral part of the male reproductive system. It secretes seminal fluid, which nourishes sperm as they grow and facilitates their transportation during ejaculation. It is located between the bladder and the rectum and surrounds the base of the urethra. Due to its location next to key parts of the urinary system, the health of the prostate gland tends to have a direct impact on the health of a mans urinary system.
The prostate gland grows larger as a man ages. While this gradual enlargement is normal, by the time a majority of men turn 50, the prostate has reached a size where it may start to affect the normal functioning of the urinary organs near it. It is at this point that a man is said to have an enlarged prostate, or clinically speaking, benign prostate hyperplasia .
Medications For Enlarged Prostate
There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors
Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostate’s size, eliminating blockage.
Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.
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What Are Enlarged Prostate Treatments
There are a wide variety of strategies for getting that prostate gland back to normal, according to Dr. Ramin. In less severe cases, he notes, it may be enough to limit coffee, tea, and sodacaffeine can stimulate the bladder and increase urinary frequency, which might be putting stress on the prostate.
In slightly more advanced situations, medications like alpha blockerswhich relax muscles in your bladder and prostate to make peeing easier, and alpha reductase inhibitors, which can shrink prostate growth, may be needed.
There are also minimally invasive treatment options like microwave therapy, Dr. Ramin says. In other cases, you may need to undergo resection of the prostate through laser therapy.
For markedly enlarged prostates, patients may need a robotic subtotal prostatectomy procedure.
The best treatment option really depends on a particular patients symptoms and results of testing, says Dr. Ramin. Not every patient with enlarged prostate is created equal, and not every treatment option is a good option for all patients.
So talk to your doctor about whats right for you. Just dont ignore the issue: Untreated enlarged prostate can lead to issues like incontinence, blood in your urinedue to inflammation from straining to peeand eventually, youre at risk for kidney damage, says Dr. Ramin.
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Diagnosis Of An Enlarged Prostate
In order to establish the possible underlying causes for an enlarged prostate, doctors will perform a variety of tests.
Tests which are commonly used to find the cause of an enlarged prostate include:
- A digital rectal exam. A physician or nurse will insert a gloved finger into the patientâs rectum to digitally examine the prostate for swelling and/or enlargement.
- Swab tests for urethral discharge or urine. To determine underlying conditions such as STIs/STDs and urinary tract infections. A swab of discharge or urine is taken and sent to a medical laboratory for culturing, so that any microorganisms are identified.
- Urinalysis. A urine sample is sent to a medical laboratory for analysis and may be tested for urea nitrogen or creatinine, among other things.
- Blood tests. A sample of blood is sent to a medical laboratory for analysis, which may include tests for creatinine or blood urea nitrogen, as well as antibodies and infectious agents.
- Prostate-specific antigen test. A blood sample is sent to a medical laboratory to be tested for prostate-specific antigen , an enzyme produced by cells in the prostate. A change in PSA levels can indicate that there is a problem with the prostate.
If patients are referred to a urologist, they may have further tests, including:
Before referring the patient for tests, the physician may also ask questions in order to determine the possible causes of the discomfort, their severity, and their duration. Such questions may cover:
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Prostatitis Vs Bph Quick Comparison Of Differences And Similarities
- Both BPH and prostatitis are problems with the prostate gland, a gland surrounding the neck of the bladder in males. The prostate gland is responsible for releasing prostatic fluid that helps make up part of the semen.
- The normal prostate gland is about the size of a walnut. As it increases in size, for whatever reason, it can press on the urethra and cause urinary problems.
- Both prostatitis and BPH can result in an enlarged prostate.
- Most men over 50 years old have some prostate enlargement with no symptoms, while bacterial prostatitis usually occurs in men younger than 35 years old and non-infectious prostatitis occurs in older men.
- You can have either BPH or prostatitis, and have no signs or symptoms. Nevertheless, both can cause pain .
- Prostatitis is caused by infections or other related health problems, while doctors dont know exactly what causes an enlarged prostate, but they think it may be related to hormones.
- BPH can be treated but not cured, but prostatitis is curable in many patients. The large majority of men with prostatitis have an infection of the prostate gland, while those with BPH do not have an infection.
What You Can Do
The best thing to do is** create a bladder diary to log your symptoms**, and bring it to your doctor. If the onset of symptoms is acute or sudden, its less likely to be BPH. Gradual onset of symptoms, and weak or slow urine flow is more likely to be BPH, or related condition. OAB is usually associated with more urinary tract infections, although there is some overlap.
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Diagnosing An Enlarged Prostate
As with all incontinence conditions, a thorough diagnosis must be developed before action can be taken. You may have heard of some of these exams. And if you havent, now is a good time to familiarize yourself with them. Not only is knowledge power, but it also eliminates surprises.
Because those with BPH can experience symptoms from mild to severe, the treatment options featured here are organized from least invasive to more intense.
Prostate Specific Antigen Testing
Prostate Specific Antigen is a protein made by the cells in your prostate. Your PSA levels can be measured using a blood test and give an indication of your prostate health.
A PSA test isnt a test for cancer. Higher levels of PSA might indicate prostate cancer, but a high reading could also be caused by other conditions. It is also possible to have low level readings and have prostate cancer. This means that a PSA test isnt enough to definitively diagnose or rule out prostate cancer. Your PSA levels can vary, so your doctor might run this test a few times to compare your results and help determine your risk of prostate cancer.
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Symptoms Of Benign Prostate Enlargement
The prostate is a small gland, located in the pelvis, between the penis and bladder.
If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that urine passes through.
This can affect how you pee and may cause:
- difficulty starting to pee
- a frequent need to pee
- difficulty fully emptying your bladder
In some men, the symptoms are mild and do not need treatment. In others, they can be very troublesome.
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At the start, prostate cancer does not cause symptoms. As the cancer grows, you may have trouble urinating. Some men need to urinate often, especially at night. Others have pain or burning during urination, blood in the urine or semen, pain in the back, hips, or pelvis, and painful ejaculation.
To find out if these symptoms are caused by prostate cancer, your doctor will ask about your past medical problems and your family’s medical history. He or she will perform a physical exam. During the exam, your doctor will put a gloved finger into your rectum to feel your prostate for hard or lumpy areas.
Your doctor may also do a blood test to check the prostate-specific antigen level. PSA levels can be high in men with an enlarged prostate gland or with prostate cancer. You may also need an ultrasound exam that takes computer pictures of the prostate.
If tests show that you might have cancer, your doctor will want to confirm this with a biopsy. He or she will take out tiny pieces of the prostate to look for cancer cells. Your doctor may want to do a biopsy again to re-check the results.
Treatment for prostate cancer depends on whether cancer is in part or all of the prostate or if it has spread to other parts of the body. It also depends on your age and overall health. Talk with your doctor about the best treatment choice for you. You may want to ask another doctor for a second opinion.
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What Is Prostate Cancer
Prostate cancer is common among American men. Your chance of getting prostate cancer may be affected by your:
- Age. Men age 50 and older run a greater risk.
- Race. Prostate cancer is most common among African-American men.
- Family history. If your father or brother has had prostate cancer, you are more likely to have it, too.
- Diet. Eating high-fat food with few fruits and vegetables may raise your risk.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia , or benign prostatic hypertrophy, is an enlargement of the prostate, a walnut-sized gland that forms part of the male reproductive system. During ejaculation, the prostate secretes fluid into the urethra, the narrow tube that runs through the center of the prostate. When a man urinates, the bladder squeezes urine out through the urethra.
As a man ages, the prostate can become enlarged. Because it surrounds the urethra right at the bladder exit, the prostate may squeeze or pinch the urethra as it gets larger over time. This may cause difficulty with urination such as a slow stream, the need to strain, increased frequency, urgency to urinate, incomplete emptying of the bladder, and intermittent flow or dribbling.
BPH is the most common disorder of the prostate gland and the most common diagnosis by urologists for males between the ages of 45 and 74. More than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
Although research has yet to pinpoint a specific cause for BPH, theories focus on hormones and related substances like dihydrotestosterone , a testosterone derivative in the prostate that may encourage the growth of cells.
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When Should You Call A Doctor For Bph
Urinary symptoms related to enlarging prostate initially affect the quality of life, and if no complications exist, as mentioned above , the decision to treat is optional and is left to the patient. This means that if you don’t feel bothered enough to take a medicine or undergo a procedure for it, you’ll need to follow up with your doctor to ensure the symptoms are stable, and the bladder empties well. This can be assessed by prostate symptom questionnaires and a measure of the strength of the urinary stream and residual urine in the bladder. If complications develop, however, or if the bladder starts holding increasing amounts of residual urine after urination, treatment should be started.
If you experience bladder pain or burning with urination, blood in the urine associated with fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospital’s emergency department.
For acute symptoms such as acute urinary retention , you should immediately go to the closest emergency medical facility for bladder drainage, usually with a catheter, which is a tube inserted into the bladder.
Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.
The Difference Between Prostate Cancer And Bph
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
During your yearly physical, your doctor might do a rectal exam or request you get a blood test to check your prostate-specific antigen level checked. If your prostate is enlarged or your PSA test comes back high, your doctor may do a biopsy to determine if your abnormal results are caused by prostate cancer or BPH. Heres what you need to know about the two conditions and their similarities and differences.
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Symptoms Of Prostate Cancer
- Frequent urge to pass urine, especially at night
- Weak or interrupted urine stream
- Pain or burning when passing urine
- Blood in the urine or semen
- Painful ejaculation
- Nagging pain in the back, hips, or pelvis
Prostate cancer can spread to the lymph nodes of the pelvis. Or it may spread throughout the body. It tends to spread to the bones. So bone pain, especially in the back, can be a symptom of advanced prostate cancer.