Almost half of all men over age 60 have some symptoms of an enlarged prostate, but many do not go to their doctor. If your symptoms are bothersome, make an appointment with your primary care provider or urologist. They can diagnose the condition and recommend treatment that will ease your symptoms and improve your quality of life.
The prostate gland is about the size of a walnut and sits just below the bladder. It produces a fluid called semen that carries sperm and is part of the male reproductive system. The prostate typically grows throughout a man’s lifetime but rarely causes problems until it gets too large. Then, it starts to squeeze the urethra, which carries urine away from the bladder, like a clamp. This is called benign prostatic hyperplasia or BPH and it’s not cancer, but the growth can cause a lot of discomfort.
Most of the time, BPH is nothing to worry about, but it can become a problem if it interferes with urinating. This can lead to a slow or delayed start to urinating, the urge to urinate frequently and in larger quantities, and difficulty emptying the bladder. In severe cases, it can also cause incontinence (an inability to control the bladder).
There are several treatments for enlarged prostate, including new techniques that are less invasive than older choices. These include water vapor thermal therapy and a procedure known as prostatectomy. During the latter, your urologist removes parts of the prostate gland through a small incision under local anesthesia or sedation. This is the procedure of choice for patients who have mild to moderate BPH with no middle lobe. It’s not recommended for patients with a middle lobe of the prostate because the procedure may not relieve symptoms completely.
A urologist can also perform a procedure called prostate artery embolization, or PAE, which involves inserting a catheter into the penis and injecting a tumescent solution into the urethra. This can reduce or even eliminate the symptoms of BPH in about 90 percent of patients, but results are not permanent. If your symptoms return, you can have more injections or surgery. Medications can be used in combination with PAE to help control your symptoms. If your enlarged prostate is not relieved by medication, your urologist will likely recommend surgery to open the area where the urethra runs through the prostate. This is typically done under local anesthesia or sedation and takes about two weeks to recover from. You’ll need to limit strenuous activity and drink lots of fluids during this period. You may experience some blood in the urine for the first few weeks after the surgery, but this should improve as you get used to your body healing. You’ll also need to visit the urologist for follow-up visits to check on your progress. The urologist can then determine if medications need to be adjusted or if more surgery is needed. Almost all men with BPH can find relief from their symptoms with the right treatment.
