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Benign Prostate Enlargement

It is common in older men

Benign Prostate Enlargement is a natural part of aging and a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems. Prostate gland enlargement rarely causes signs and symptoms in men younger than age 40. About one-third of men experience moderate to severe symptoms by age 60 and about half do so by age 80. In men, urine flows from the bladder through the urethra.

Benign Prostate Enlargement is a noncancerous enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra — the “chute” through which urine and semen exit the body. As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.

Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.

Risk factors for prostate gland enlargement include aging, family history, diabetes and heart disease and lifestyle.

Symptoms of enlarged prostate can include:

  • A weak or slow urinary stream
  • A feeling of incomplete bladder emptying
  • Difficulty starting urination
  • Frequent urination
  • Urgency to urinate
  • Getting up frequently at night to urinate
  • A urinary stream that starts and stops
  • Straining to urinate
  • Continued dribbling of urine
  • Returning to urinate again minutes after finishing

Similar Symptoms

Benign Prostate Enlargement and prostate cancer have similar symptoms, and a man who has BPE may have undetected cancer at the same time.

The American Cancer Society recommends that men make an informed decision with their healthcare provider whether to be screened for prostate cancer.  For men at average risk, this discussion should start at age 50. Men at an even higher risk, such as having several relatives with a history of prostate cancer at an early age, should consider testing at age 40.

Your doctor will start by asking detailed questions about your symptoms and doing a physical exam. This initial exam is likely to include a digital rectal exam, a urine test, a blood test and a Prostate-specific antigen (PSA) blood test. After that, your doctor might recommend additional tests to help confirm an enlarged prostate and to rule out other conditions. These tests include urinary flow test, post-void residual volume test and 24-hour voiding diary.


A wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery. Medication is the most common treatment for mild to moderate symptoms of prostate enlargement. The options include alpha blockers, 5-alpha reductase inhibitors and combination drug therapy. To help control the symptoms of an enlarged prostate, try to limit beverages in the evening, follow a healthy diet, stay active, urinate  and then urinate again a few moments later (also called double voiding).

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