long lasting prostate

Overview

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is a non-cancerous growth of the prostate gland. The prostate is a small gland in men that surrounds the tube carrying urine from the bladder. When it gets larger, it can squeeze the urethra and make urinating difficult. It is not cancer and does not lead to cancer.

Yes, BPH is very common. About half of men over 50 have some symptoms, and nearly 90% of men over 80 have an enlarged prostate.

BPH mainly affects men over 40. It is rare in younger men. The risk increases with age, and men with a family history of BPH are more likely to develop it.

Symptoms

Common symptoms

• Needing to urinate often, especially at night (nocturia)
• A sudden, strong urge to urinate (urgency)
• Difficulty starting to urinate (hesitancy)
• A weak or slow urine stream
• Stopping and starting again while urinating (intermittency)
• Feeling like you haven't emptied your bladder completely
• Dribbling after urinating

Symptoms in older adults

• Same symptoms as common ones, but older adults may also have worsening night-time urination, increased risk of falls when rushing to the toilet, and a higher chance of urinary tract infections.

Causes

Main causes

• Age-related changes in hormone levels, especially an increase in dihydrotestosterone (DHT), which can stimulate prostate growth.
• Changes in growth factors that regulate prostate cell division.

Risk factors

• Age (over 40)
• Family history of BPH
• Obesity
• Lack of physical activity
• Erectile dysfunction

When to see a doctor

See a doctor urgently if:

• If you cannot urinate at all – go to the emergency department immediately.
• If you see blood in your urine that is bright red or has clots.
• If you have a fever or severe pain in your lower belly or back.

Book a routine appointment if:

• If your symptoms bother you or affect your daily life.
• If you have noticed a change in your urination pattern.
• If you have frequent urinary tract infections.

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. They may also do some simple tests to confirm the diagnosis and rule out other causes.

Tests that may be done

• Digital rectal exam (DRE) – the doctor feels the prostate through the rectum to check its size and firmness.
• Urine test (urinalysis) – to check for infection or blood.
• Blood test for prostate-specific antigen (PSA) – a high level can indicate BPH or prostate cancer.
• Ultrasound of the bladder and prostate – to see how well you empty your bladder and the size of the prostate.
• Flow rate test – measures the speed of your urine stream.

What to expect at your appointment

The tests are usually quick and done at your doctor's office. They are not painful, though the DRE may feel uncomfortable for a few seconds. Your doctor will explain the results and discuss next steps.

Treatment

Treatment depends on how much your symptoms bother you. Options range from simple lifestyle changes to medications or procedures. Your doctor will help you choose what is best for you.

Self-care at home

• Limit drinks in the evening, especially caffeine and alcohol, to reduce night-time urination.
• Try to double void – after urinating, wait a minute and try to go again.
• Avoid decongestants and antihistamines if possible, as they can worsen symptoms.
• Do pelvic floor exercises (Kegel exercises) to strengthen muscles that help control urination.

Medical treatments

Medications can help relax the muscles around the prostate or shrink the prostate over time. Common types include alpha blockers (which help urine flow) and 5-alpha reductase inhibitors (which reduce prostate size). Your doctor will discuss the best option for you. Always take medication exactly as prescribed.

When is surgery considered?

If medications do not help or symptoms are severe, your doctor may recommend a procedure to remove or reduce prostate tissue. Options include transurethral resection of the prostate (TURP) or laser therapy. These are usually done through the penis without external cuts.

Living with this condition

BPH can affect your daily life, especially if you need to urinate often. Plan ahead – know where toilets are when you go out. Use the bathroom before long trips. Wear dark pants or use absorbent pads if you are worried about leaking. You can still lead an active life.

Lifestyle tips

• Stay physically active – walking, swimming, or cycling can help improve symptoms.
• Avoid large amounts of fluids before bed.
• Manage stress – relaxation techniques can reduce urinary urgency.
• Stop smoking – smoking can irritate the bladder.

Diet and exercise

A healthy diet rich in fruits, vegetables, and lean protein may help. Some studies suggest that tomato products (cooked), pumpkin seeds, and saw palmetto may be beneficial, but check with your doctor first. Regular exercise helps maintain a healthy weight and can reduce symptoms.

Mental health and emotional wellbeing

Living with BPH can be frustrating or embarrassing. It may cause anxiety or affect your sleep. If you feel overwhelmed, talk to your doctor or a counselor. Reach out to a crisis support service in your area if you need immediate help.

Prevention

There is no sure way to prevent BPH, but a healthy lifestyle may lower your risk. Maintaining a healthy weight, eating a balanced diet, and staying active are good for your prostate and overall health.

Screening programmes

There is no routine screening for BPH. However, if you are over 40 and have symptoms, talk to your doctor. They may recommend a PSA test or other checks.

Complications

If left untreated

• Acute urinary retention – sudden inability to urinate, which is a medical emergency.
• Bladder stones – from urine staying in the bladder too long.
• Frequent urinary tract infections.
• Bladder damage or kidney damage from long-term backflow of urine.

Long-term outlook

The outlook for BPH is very good. Most men can manage symptoms with lifestyle changes or medications. Even if you need surgery, it is usually safe and effective. BPH does not lead to cancer, and treatment can greatly improve quality of life. With proper care, you can continue to enjoy life.

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