An enlarged prostate can be a problem or issue that many men face as they turn 50. By age 55, 1 in 4 men may experience some issues. By age 65, the figure is up to nearly 75 percent, and by age 80, nine in 10 men have BPH. Normally half of these men will have symptoms that warrant treatment.[1] Another name for this condition is benign prostatic hyperplasia (BPH) and prostatic hypertrophy. There are a lot of treatments for this condition and it is important to know something about them before you see your doctor.
Signs of this condition can include the following:
Weak Urine Stream
Difficulty Starting Urination
Stopping and Starting while urinating
Dribbling at the end of urination
Frequent or urgent need to urinate
Increased frequency at night (nocturia)
Straining while urinating
Not being able to completely empty the bladder
Urinary tract infection
Formation of stones in the bladder
Reduced Kidney Function [2]
“Only about half the men with prostate gland enlargement have symptoms that become noticeable or bothersome enough for them to seek medical treatment. In some men, symptoms eventually stabilize and may even improve over time.”[3]
When you see your doctor you may want to prepare a list of questions. One is to ask for a simple blood test called a (prostate specific antigen) PSA. This can help rule out cancer. Another test that your doctor may want to do is a rectal screening to examine the prostate.
- You should describe how often and frequent you urinate and what problems you are experiencing.
- Note any back pain that you might be having, how often and how frequent it is occurring.
- Also bring a list of medications both prescribed and anything over the counter that you might be taking.
Additional questions you should be prepared to ask should involve:
- What treatment do you recommend and what alternatives if any exist?
- Should I see a Urologist?
- What are the risks with the treatment?
- Can this treatment affect other medical conditions that I have?
- Are there other alternatives to what you are suggesting? What are the risks?
- How will this treatment affect sexual activity?
Other disease processes that can present urinary symptoms similar to those caused by enlarged prostate include:
- Bladder stones
- Bladder and urinary tract infections
- Diabetes
- Neurological problems
- Inflammation of the prostate (prostatitis)
- Prostate cancer
- Stroke
- Muscle and nerve (neuromuscular) disorders
- Scarring or narrowing of the urethra[4]
Treatment can vary and cost can vary depending on what is prescribed. Your doctor may treat your condition with alpha-blockers and 5-alpha-reductase inhibitors. In addition your doctor could surgery in more severe cases.
Low blood pressure caused by the alpha-blocker medicines can fall to dangerous levels if you’re also taking a high blood pressure drug or erectile dysfunction medicines such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). This category of drug is also not recommended for men who might need cataract surgery in the future. The side effects of the 5-alpha-reductase inhibitors can include a reduced sex drive and difficulty achieving and maintaining an erection although this has been reported as rare. Men who plan on continuing to have children should also not take this drug category because it can cause birth defects. Finally low dose Cialis has been shown to help treat both ED and BPH in men and has been cleared by the FDA for these purposes.
Whatever treatment you and your doctor choose make sure you are informed. Have a clear understanding of the treatment and procedures prescribed and don’t avoid seeing the doctor as you are not alone. BPH is more common than most men realize. It is probably a topic that most do not talk about out of shame or embarrassment and it should not be approached in that manner.
[1] Evaluating Drugs Used to Treat: Enlarged Prostate Comparing Effectiveness Safety and Price. Consumer Reports Health Best Buy Drugs. May 2012. http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/BBD_Prostate_Enlargement.pdf
[2] Prostate gland enlargement. Mayo Clinic. http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027/DSECTION=symptoms
[3] Ibid
[4] Ibid http://www.mayoclinic.com/health/prostate-gland-enlargement/DS00027/DSECTION=tests-and-diagnosis