Enlarged Prostate Enlarged Prostate

Enlarged Prostate: What Does It Mean?

Recent estimates from the National Institute of Health (NIH) indicate that as many as 50% of men over age 60 and 90% of men over age 70 have an enlarged prostate, sometimes called "benign prostatic hyperplasia," or "BPH." Though researchers don't know exactly what triggers the onset of BPH, it is thought that hormonal changes may contribute to enlarged prostate symptoms and conditions. The first thing most men think of if they have enlarged prostates is prostate cancer, but the good news is that just because you have an enlarged prostate doesn't necessarily mean you have cancer.

Background

The prostate is a walnut-sized, doughnut-shaped gland that surrounds the urethra. It is located below the bladder and in front of the rectum. Sometimes, the cells around the urethra begin to grow, squeezing the urethra like a pinched soda straw. In other instances, cells in the middle lobe of the prostate grow into the urethra and the area of the bladder outlet. This type of BPH generally requires surgical correction.

Who Is at Risk for Enlarged Prostate?

Nearly all men over the age of 50 have some enlargement of the prostate. In fact, age is the primary known risk factor for enlarged prostate. As mentioned above, the precise cause or trigger for BPH is not known, but hormonal effects are believed to be associated with the condition. Testosterone, produced in the testes, is converted by the body into dihydrotestosterone (DHT) and estriadol (estrogen). Some researchers believe that high levels of DHT, a hormone associated with prostate growth, may begin to accumulate in the tissues and contribute to abnormal prostate growth. Researchers are still trying to figure out why DHT levels rise in older men, and exactly how the hormone affects prostate growth.

How Do I Know if I Have Enlarged Prostate?

The most common signs of BPH include difficulty in urinating; restricted or intermittent flow of urine; blood in the urine (often caused by straining to produce urine flow); dribbling after urination; a persistent feeling of needing to urinate; and a recurrent, sudden, urgent need to urinate. In more severe cases, acute urinary retention can occur, a condition where the urinary sphincter is unable to relax sufficiently to allow the flow of urine. This problem can be made worse by certain prescription or over-the-counter drugs (especially antihistamines and decongestants) containing epinephrine, ipratropium bromide, or albuterol. In the most severe cases, catheterization may be the only way to gain relief.