Signs You Shouldn't Take Testosterone TherapyWebMD archives content after 2 years to ensure our readers can easily find low testosterone enlarged prostate most timely content. To find the most current information, please enter your topic of interest into our search box. All his life, he slept like a stone. But now, there's an annoying trip to the bathroom every night, sometimes once or twice a night. For most prostahe, these nightly bathroom runs may be the first sign of an enlarged prostate.
Enlarged Prostate Causes, Symptoms, and Treatments
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All his life, he slept like a stone. But now, there's an annoying trip to the bathroom every night, sometimes once or twice a night. For most men, these nightly bathroom runs may be the first sign of an enlarged prostate. Other symptoms may include trouble starting a stream of urine, leaking, or dribbling. And, like gray hair , an enlarged prostate is a natural by-product of getting older, doctors say.
Trouble is, the nightly bathroom runs become more frequent -- eventually edging their way into the daytime routine. It's a problem that has several names -- enlarged prostate , benign prostate hyperplasia, or simply BPH. According to the National Kidney and Urological Disease Information Clearinghouse, the most common prostate problem for men over 50 is prostate enlargement. In men, urine flows from the bladder through the urethra. BPH is a benign noncancerous enlargement of the prostate that blocks the flow of urine through the urethra.
The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra -- the "chute" through which urine and semen exit the body. As the urethra narrows, the bladder has to contract more forcefully to push urine through the body. Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently.
Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied. When the bladder does not empty completely, you become at risk for developing urinary tract infections.
Other serious problems can also develop over time, including bladder stones, blood in the urine , incontinence , and acute urinary retention an inability to urinate. A sudden and complete inability to urinate is a medical emergency; you should see your doctor immediately.
Most men put up with an enlarged prostate for months, even years, before seeing a doctor, says Slawin. It's not always obvious what's going on, Slawin adds. They should see a doctor when anything changes, because there can be bladder cancer , stones, prostate cancer. BPH is often a diagnosis of exclusion … after we make sure nothing more serious is going on. Higher scores indicate more severe symptoms. Prostate growth -- and the trouble it causes -- varies greatly from person to person, says O.
Some people with very large prostates don't have trouble with voiding. It's a very individual thing. When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index less than 8 , it may be best to wait before starting any treatment -- what's known as "watchful waiting. With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience.
The "driving force in treatment," she explains, is whether the symptoms are affecting your quality of life -- and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure , or other bladder problems. A range of treatments can relieve enlarged prostate symptoms -- medications , minimally-invasive office procedures, and surgery. The best one for you depends on your symptoms, how severe they are, and whether you have other medical conditions.
The size of your prostate gland, your age, and your overall health will also factor into treatment decisions. What's best for a man in his 50s might not be optimal for an year-old. An older man may want immediate symptom relief through drugs or surgery, whereas a younger man may lean toward a minimally invasive treatment.
According to the American Urological Association, surgery often does the best job of relieving symptoms, but it also has more risks than other treatments. Consider the options carefully with your doctor, says Westney. If symptoms are really bothersome -- or if you have complications like urine retention -- it may be best to bypass medication.
The minimally invasive treatments have benefits over surgery, like quick recovery time; however, you may need a second procedure later on. There is also less risk of serious side effects like long-term incontinence or erection problems -- which can occur rarely with surgery.
Several drugs are FDA-approved to relieve common symptoms of an enlarged prostate. Each works differently, says Westney. They either shrink the enlarged prostate or stop the prostate cell growth, she explains. These drugs don't reduce the size of the prostate, but they are very effective at relieving symptoms.
They work by relaxing the muscles around the prostate and bladder neck, so urine can flow more easily. These drugs work quickly, so symptoms improve within a day or two. They are most effective for men with normal to moderately enlarged prostate glands. Flomax tamsulosin , Uroxatral alfuzosin , Hytrin terazosin , Cardura doxazosin , and Rapaflo silodosin.
Alpha blockers were originally created to treat high blood pressure ; dizziness is the most common side effect; other side effects are generally mild and controllable. Possible side effects include headache , stomach irritation, and stuffy nose. These drugs are not for men with significant urine retention and frequent urinary tract infections. These drugs can partially shrink the prostate by reducing levels of a male hormone -- dihydrotestosterone DHT -- which is involved in prostate growth.
These drugs take longer to work than alpha blockers, but there is urine flow improvement after three months. These drugs can reduce risk of acute retention inability to urinate -- and also reduce the need for prostate surgery.
You may need to take them for 6 to 12 months to see if they work. Proscar finasteride and Avodart dutasteride. Possible side effects include erection problems, decreased sexual desire, and reduced amount of semen.
These side effects are generally mild and may go away when you stop taking the drugs -- or after the first year of taking the drugs.
There is also drug combination therapy, which may be effective against symptoms associated with BPH. Some examples of combined drugs include an alpha-blocker and a 5-alpha-reductase inhibitor; or an alpha-blocker and an anticholinergic.
When medications don't help your enlarged prostate, several procedures can relieve symptoms -- without surgery. They are performed in a doctor's office. TUMT transurethral microwave thermotherapy: This therapy for mild to moderate blockage reduces urinary frequency, urgency, straining, and intermittent flow -- but does not correct any bladder-emptying problems.
In this procedure, computer-regulated microwaves are used to heat portions within the prostate to destroy select tissue. A cooling system protects the wall of the urethra during the procedure. TUMT is performed in a doctor's office and requires only topical anesthesia and pain medications. Possible side effects include painful urination for several weeks. Temporary urgency and frequency of urination is also possible.
There may be less semen ejaculated. Many men must have this procedure repeated, either because symptoms return or do not improve. TUNA transurethral radio frequency needle ablation: This procedure also destroys prostate tissue to improve urine flow and relieve symptoms.
It involves heating the tissue with high-frequency radiowaves transmitted by needles inserted directly into the prostate some anesthesia is used.
The procedure does not require a hospital stay. Possible side effects include painful, urgent, or frequent urination for a few weeks. In some cases, a tiny metal coil called a stent can be inserted in the urethra to widen it and keep it open. Stenting is done on an outpatient basis under local or spinal anesthesia. Usually, stents are only for men who are unwilling or unable to take medications -- or who are reluctant or unable to have surgery.
The majority of doctors don't consider stents a good option for most men. There could be serious side effects, and some men find that stents don't improve their symptoms. Sometimes a stent shifts position, which can worsen the symptoms. In some cases, men experience painful urination or have frequent urinary tract infections.
Stents are expensive, and there can be difficulty in removing them. For most men with very enlarged prostates, surgery can relieve symptoms -- but there are both risks and benefits with each type of operation. Discuss them with your doctor. After a careful evaluation of your situation and your general medical condition, your doctor will recommend which is best for you.
TURP transurethral resection of the prostate: This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.
With the TURP procedure, patients can expect to have retrograde ejaculation afterwards, says Westney. This is a condition in which a man ejaculates backward into the bladder instead of through the urethra. However, this is often temporary -- and the ability to have an erection and an orgasm returns after a few months.
TUIP transurethral incision of the prostate: This procedure involves making cuts in the prostate instead of removing prostate tissue. These cuts reduce pressure on the urethra, making urination easier. Patients go home the same day, and wear a catheter for a day or two.