An enlarged prostate gland is a common health problem among men. In practice, I have come across hundreds (if not more) cases of large prostate glands over the years.
Before I go ahead with this article, I just want to let you know that having an enlarged prostate gland does not mean you have cancer. Some people mistake a large prostate gland for possible cancer.
Today, I will discuss some of the commonly asked questions about enlarged prostate and also guide you as to when to seek help.
But first, a bit about the prostate gland.
What Is The Prostate Gland?
The prostate gland is a small gland located in the groin area. It is the size of a walnut.
To be more accurate, the prostate gland is located just below the bladder, as is seen in the picture below. It lies just in front of the rectum.
The urethra (the tube that carries urine from the bladder) lies within the prostate gland. If the prostate is enlarged, it can compress this urethra, making it difficult to pass urine.
I have discussed this aspect a little later in this article.
What Is The Function Of The Prostate Gland?
The prostate gland is responsible for the production of a sticky liquid substance. This liquid forms a part of the sperms that are ejaculated during sexual intercourse. The fluid helps keep the sperm healthy and nourished.
The prostate gland has an important role during our younger years, as it helps with reproduction. However, once the age to have children has passed, the prostate gland becomes useless. Taking out the prostate gland will have no effect on the individual or on sexual activity.
What Is An Enlarged Prostate Gland?
So, what does an enlarged prostate mean? In simple terms, it is a larger-than-normal prostate.
The normal prostate is around the size of a walnut and weighs up to 20 grams. A prostate that measures and weighs more than this is called an enlarged prostate.
The increase in size and weight can be dramatic. I have personally seen prostate glands measure over 120 grams on ultrasound scans (they will be the size of a tennis ball!).
An enlarged prostate gland is sometimes called BPH, or benign prostatic hypertrophy.
What Are The Causes Of An Enlarged Prostate?
The most common reason why the prostate gland enlarges is advancing age. As men get older, the prostate gland begins to grow slowly.
This growth of the gland with age is completely normal. It is sometimes called benign prostatic hypertrophy, or BPH.
The prostate gland can also enlarge in more serious conditions such as prostate cancer. Prostate cancer is the most common type of cancer in men. Early treatment carries a good long-term prognosis.
In this article, I have only discussed age-related prostate enlargement. I will discuss prostate cancer soon.
What Happens If The Prostate Becomes Big?
If the prostate gland becomes bigger, it can start to cause certain symptoms in some men.
These symptoms will not be evident during the early stages of the condition. However, as it gets larger, symptoms begin to appear. This is because the prostate puts pressure on the base of the bladder and narrows the urethra.
It is important to remember that even if the prostate is very enlarged, the patient may not have any symptoms. Similarly, only mild enlargement of the gland can cause symptoms in some patients.
I have listed these in the table below.
Those who have an enlarged prostate gland may find that these symptoms get worse as time passes. It may be quite some time before the symptoms become worrying enough to seek medical attention.
If the symptoms occur over a short period of time, then there may be another reason for it other than the prostate.
Some of the symptoms may be worsened by certain medications (cold medicines, diuretics, etc.), cold weather, and stress.
Why Does The Prostate Become Big?
It is believed that there may be some hormonal factors that play a part in the enlargement of the prostate. The prostate may also enlarge if cancer is present.
It is important for every person who has an enlarged prostate to make sure they do not have cancer.
Tests For Enlarged Prostate Gland
So your doctor believes you have an enlarged prostate gland. It is possible this diagnosis has been made because of the symptoms you have been experiencing.
What tests will you be asked to undergo?
The first test would be a simple urine test. This test will help the doctor differentiate whether you have symptoms from prostate enlargement or from a urinary infection.
The sample can be taken at any time of the day. It does not require an overnight fast.
The next test would be an ultrasound scan of the prostate gland. This will help determine the size of the prostate, whether the surface is smooth, and whether it is blocking the flow of urine.
The ultrasound scan should be done on an empty stomach and a full bladder. You may be asked to drink water till your bladder is full.
The scan is done in 2 phases. In the first phase, the prostate gland is measured and the quantity of urine in the bladder is determined. In the second phase, the patient is asked to pass urine and the quantity remaining is assessed.
If the prostate is causing problems, there will be a large amount of urine still left in the bladder after voiding.
Prostate Specific Antigen (PSA)
The PSA test is a blood test that looks at the levels of a compound released by the prostate gland. If the prostate is enlarged due to age, the PSA may be normal or mildly elevated.
In patients with suspected cancer, the PSA is markedly elevated.
Your doctor will let you know if the PSA elevation is significant or not.
A prostate biopsy is reserved for patients in whom prostate cancer is suspected or needs to be ruled out.
The biopsy helps yield cells that can be seen under a microscope. A biopsy is not really necessary if the prostate is simply enlarged. However, if the test is done, it can confirm age-related enlargement and effectively rule out cancer.
How Is An Enlarged Prostate Treated?
A slightly enlarged prostate that is not causing any symptoms does not require any treatment.
Even a very large prostate not causing symptoms does not need any treatment.
However, if you are experiencing any of the symptoms I mentioned in the box above, then you will need medical treatment. Medicines are available that can help ease the pressure that the prostate puts on the urethra. This can help you pass urine a lot more freely.
However, if the medicines do not work, then additional treatments may be needed.
One complication of an enlarged prostate is the retention of urine. This is a condition where the patient cannot pass urine, and the bladder becomes enlarged and painful in the process. Catheter insertion is needed to drain the urine.
If a urinary obstruction occurs in patients with an enlarged prostate, then surgical removal of the prostate is needed. This is now done through a procedure called TURP. Here, the prostate gland is removed with a laser with good results.
Simple Tips To Relieve Symptoms
An enlarged prostate can lead to a variety of symptoms as I have discussed above.
Here are some tips to help relieve these at home.
1. Stress can increase the urinary frequency if you have a large prostate. Take up measures such as yoga and meditation to reduce your stress.
2. Take your time in the bathroom. Starting a urinary stream is hard, and often the bladder does not empty completely. Take time to pass urine. If you are embarrassed to use public open-space urinals, use a cubicle where you can get some privacy.
3. Avoid drinking water late in the night. The more you drink, the more urine you produce. This would only make you wake up a lot more frequently at the night.
You should also (if possible) avoid caffeinated drinks and alcohol.
4. Some over-the-counter medicines may worsen your symptoms. Discuss these with your doctor before you take them. You may need a change in your medicines.
Can an enlarged prostate turn into cancer?
No. Benign prostate enlargement does not turn into cancer.
Will I have problems having children?
An enlarged prostate gland does not affect your ability to father children.
Does an enlarged prostate affect erection?
Fortunately, it does not!
Before I close, here is a presentation that recaps the entire article –
An enlarged prostate gland is a common problem and can be due to a number of reasons. If age-related, treatments are simple and patients can lead a completely normal quality of life.
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Updated April 16th, 2023 by Dr Vivek Baliga