Symptoms of an Enlarged Prostate

An enlarged prostate is something you might hear talked about more and more. It’s one of the things that naturally can affect a man as he ages. But what exactly is the problem with an enlarged prostate?

When a man’s prostate becomes enlarged it can cause all kinds of problems in his lower body. There will usually be some signs that might tip you off that it is getting bigger though. It’s important to watch out for these signs as they can give you an early warning to get yourself checked out before any problems become much worse.

What happens when your prostate enlarges?

An enlarged prostate can be a big problem for a man. The prostate gland is located between the bladder and penis, and is usually around the size of a walnut or small plum. It continues growing for your entire life, and in some cases can even reach the size of a small grapefruit.

When it is working correctly, it is responsible for controlling the liquids that exit your penis, switching between ejaculation and urination as necessary. This means there are several intricate and small bits of pipework that go through and around the prostate. As a prostate grows, these pipes will become squashed, making it harder for fluid to move through them.

What symptoms are there of an enlarged prostate?

An enlarged prostate isn’t necessarily a problem for a lot of men. As it continues growing for your entire life, it is somewhat of a natural process, and some men will have no problems whatsoever. There are some key things you can look out for though as signs of trouble brewing.

Some of the most common symptoms you might experience are:

  • Waking up at night to urinate
  • Difficulty when urinating
  • Slow or low flow of urine
  • Starting and stopping during urination
  • Very frequent urination
  • Feeling like you aren’t finished after urinating
  • Having to push harder to urinate
  • Urinary infections
  • Not being able to urinate at all
  • Dribbling at the end of urination
  • Difficulty delaying urination

If you are feeling some, or all of these symptoms, its usually best to get checked out by your doctor as soon as possible. While most prostate growth is natural and most problems can be treated quite easily with antibiotics, sometimes it can be more serious.

Getting checked up

How your doctor examines your prostate gland wil usually involve both a physical examination, and an evaluation through some simple questions. The questions used are usually the ones designed by the American Urological Association (AUA), and you answer on a scale rating how common each scenario is to you. Based on your answers, your doctor will be able to make a judgement on how severe your situation is.

Your doctor will then usually perform one of a few types of physical examinations. The most common of these will be a Digital Rectal Examination, or to put it more simply, the doctor will insert a gloved finger and have a feel of your prostate to see what’s going on. If this doesn’t give the answers desired, they might then choose to perform tests on either your urine or your blood to check for infections or diseases.

If you are confirmed to have an enlarged prostate, your doctor may want to run some additional tests to find the exact cause and how severe the situation is. These tests can include: Ultrasound imaging of both your prostate and bladder, studies of your urinary flow and bladder post urination, and sometimes a cystoscopy where a small imaging tube is inserted into the urethra for a direct look at the prostate.

Treatments for Enlarged Prostate

Once your doctor has determined whether or not your enlarged prostate is a problem, and what exactly may be causing the problem, they will choose an appropriate course of treatment for you.

In some cases, a simple course of antibiotics will be enough to clear up any issues you might be having. When this doesn’t work, there are a couple of other options the doctor might want to take.

One option is Alpha-Blocker medication. These were originally designed to help with high blood pressure and work by relaxing the muscles around the prostate and bladder, making it easier to urinate. While they don’t directly treat the prostate, they are effective at relieving some of the symptoms.

The other option are drugs called 5-alpha reductase inhibitors. While the name is a bit of a mouthful, the function is actually quite simple. A male hormone called dihydrotestosterone is a key part in prostate growth. The inhibitors reduce your levels of dihydrotestosterone which in turn reduces the amount of prostate growth you experience.

Both of these treatment options aren’t without their own risks. You may experience headaches, stomach problems, dizziness, erection problems, decreased libido, or many others. It is important that the doctor is able to properly diagnose any problems you’ve been having so they can give you the appropriate treatment, so try to be as honest and open with them as possible, even if it is an embarrassing subject.

Last treatments before surgery

When medications aren’t working on clearing up your prostate problems, there are still options the doctor can take before turning to surgery. These can usually be done in a doctor’s office and involve shrinking the prostate to ease the problems. There are three types of therapy the doctors can perform.

TUNA (transurethreal radio frequency needle ablation) is a procedure done under local anasthetic. Needles are inserted directly into the prostate and transmit radio waves to heat up the tissue. By using heat, some of the prostate tissue is destroyed, opening up more room for the urine to pass through the prostate and out of the urethra.

ILT (insterstitial laser therapy) is also done under local anasthetic. This involves inserting a cystoscope through the urethra, and passing a laser fibre through it to puncture the prostate. Once punctured, the fibre heats the prostate to destroy some of the tissue and shrink the gland.

TUMT (transurethral microwave therapy) is probably the least painful of the three, as it doesn’t require general anasthesia but a topical anasthetic and painkillers. This therapy uses microwaves to directly target areas of the prostate that need destroying.. At the same time, certain areas are cooled to prevent uintentional damage to the surrounding tissue.

Surgery for enlarged prostates

As a last resort, your doctor may recommend undergoing surgery to help deal with your prostate problems. Many of these are also not as invasive as you might think, and open surgery will generally only be a truly last resort.

Laser Surgery actually takes on many forms when used for prostate shrinking. While the actual method may differ, the intention is the same throughout. The laser acts as a high energy vaporiser, and destroys areas of the prostate, allowing urine to flow properly again. Sometimes laser surgery will require you to stay at the hospital overnight.

TUIP (transurethral incision of the prostate) is a slightly different procedure. Rather than destroying areas of the prostate to reduce the pressure, small incisions are made into the tissue. These incisions help the urethra to begin to function properly again, and patients are usually able to go home the same day.

TURP (transurethral resection of the prostate) is the most common treatment patients will have if they need surgery. An electrical loop is used to cut very specific sections of the prostate that are applying pressure to the urethra. Most doctor’s will recommend this as it is the least invasive form of treatment available.

Prostatectomy (Open Prostate Surgery) is the last option when all other procedures and medictions have been tried or aren’t appropriate. It is only used in situations where the prostate is extremely enlarged, or if damage is beginning to affect other areas of the body. An incision is made into the abdomen and the inner layers or the prostate are removed, to ease pressure on the urethra.

While surgery is the last resort in prostate treatment, it isn’t without it’s own risks. All of the surgical treatments have their own potential side effects, some of which might never be recovered from. The most common side effects tend to be urinary problems or erection problems, but these tend to pass with time. There is also a risk of retrograde ejaculation (where ejaculate moves back to into the bladder rather than out of the body). This isn’t particularly painful but can cause fertility problems, so you should discuss this with the doctor if you intend to have children.

While there are a lot of different treatments and some of them sound a little terrifying, you should try not to worry too much about it. At the end of the day, not having your prostate treated or examined could put you in a much worse position, so if you experience any of the symptoms listed you should get checked out as soon as possible. Before you know it you’ll be back to normal with a nice healthy prostate.