Should I be concerned about an Enlarged Prostate?

An enlarged prostate, known in the medical field as benign prostatic hyperplasia (BPH), is a really common condition in men particularly those over 50 that can make going for a pee more difficult.  You might have also heard it being called Benign prostate enlargement (BPE).

An enlarged prostate, as the name suggests, is when the prostate gets bigger. This usually affects how you pee. This is because as the prostate gets bigger it restricts the flow of urine out of the bladder due to the pressure it exerts on the pee tube – this runs through the middle part of the prostate that carries urine to the penis (known as the prostatic urethra). This can cause symptoms such as:

• finding it difficult to start peeing
• straining to pee
• having a weak flow of urine
• “stop-start” peeing
• needing to pee urgently and/or frequently
• needing to get up frequently in the night to pee
• accidentally leaking urine (urinary incontinence)

Leaking urine can happen either when there is a sudden need to pee but some pee leaks out before getting to the toilet. This is called urge incontinence. Or when there is some sort of strain, like coughing, sneezing or lifting a heavy object. This is called stress incontinence.

There are medications that can treat these symptoms.

What causes an enlarged prostate?

We don’t know why the prostate gets bigger, but some say it might be due to hormone changes as a man gets older. This theory states that the cause is due to an increased oestrogen to testosterone ratio which is associated with ageing, which leads to the prostate getting larger.

Benign prostate enlargement (BPE) actually refers to an increase in volume of the prostate due to benign prostatic hyperplasia (BPH). BPE can then result in the obstruction of the pee tube known as Benign prostatic obstruction (BPO) which leads to the symptoms described.

Does an enlarged prostate increase the risk of prostate cancer?

There is generally no cause for concern if you have an enlarged prostate, it does not cause a serious threat to your health and has no impact on your risk of getting prostate cancer. It just has some annoying symptoms, which can be treated using medication.

You can take medication to treat an enlarged prostate and this will depend on how severe the symptoms are. Having an enlarged prostate can lead to some complications, and these can include:

• a urinary tract infection (UTI) – an infection of the urinary tract
• chronic urinary retention – when your bladder does not empty in full you can still pee a little.
• acute urinary retention – is the sudden inability to pass any urine.

Treating an enlarged prostate

Treatment of an enlarged prostate usually centres on managing the symptoms it causes.  A medication called Tamsulosin is one commonly prescribed to men with an enlarged prostate. Other medications include Doxazosin and Alfuzosin. These medications belong to a group called Alpha-adrenoceptor blockers. The medication works by relaxing the smooth muscles of the prostate and urethra, and leads to improved urinary flow.

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Other treatments can include medications used to relax the bladder muscle if it’s overactive called anticholinergics and help shrink the prostate gland called 5-alpha reductase inhibitors like Finasteride and dutasteride.

• Lifestyle changes may also help relieve the symptoms such as:
• Fewer fizzy drinks, less alcohol, caffeine and artificial sweeteners
• Drinking less fluid in the evening
• Emptying your bladder before long journeys
• Take a few extra moments after having a pee before going again
• Eating more fibre

Summary

• An enlarged prostate is very common and not usually a concern
• It does not increase your risk of prostate cancer
• Treatment involves managing the symptoms