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Enlarged Prostate

Enlarged Prostate

An enlarged prostate is a common condition in older men - around 60% of men who are 60 or over have some degree of prostate enlargement. The prostate is the small gland located between the penis and the bladder. If the gland becomes enlarged it can put pressure on the bladder and urethra (the tube that connects the bladder to the penis) causing problems such as difficulty urinating, a frequent need to urinate or difficulty emptying the bladder. The condition can be mild or severe. While it causes distress and discomfort an enlarged prostate does not increase your risk of developing prostate cancer.

Symptoms

  • Difficulty starting to urinate
  • Frequent need to wee
  • Blood in the urine
  • Weak flow of urine so you stop & start
  • Inability to fully empty bladder
  • Sudden urge to urinate & possible incontinence

What causes prostate enlargement?

As men age the levels of sex hormones start to change and it’s thought this may cause prostate enlargement in some men. A rise in the hormones dihydrotestosterone (DHT) and oestrogen, together with a drop in testosterone levels are thought to stimulate the growth of the prostate.

How is prostate enlargement treated?

If symptoms are mild you will initially be advised to make lifestyle changes including exercising regularly, reducing liquid intake before bedtime and limiting alcohol and caffeine intake. You may also be offered ‘bladder training’ - an exercise programme that teaches you how to increase the time between urination.

Medication may get prescribed if symptoms are moderate to severe. Medications prescribed include finasteride and dutasteride which block the impact of the hormone DHT on the prostate gland. You may also be given alpha blockers to help relax your bladder muscles to make urination easier. A ‘Memokath stent’ can also be used to help your urinate more easily. The stent is a tiny spring inserted under local anaesthetic that holds open the urethra to assist urination.

If these methods aren’t successful, surgery may be offered. Transurethral resection (TURP) is the most effective operation. It involves inserting a wire loop into the urethra allowing the obstructing prostate to be removed without external scarring.

Other surgical procedures include Transurethral incision of the prostate (TUIP) in which small cuts are made in the prostate to widen the urethra, prostatectomy - to remove the outer portion of the prostate (only advised for severely enlarged prostate), laparoscopic (keyhole) prostatectomy and laser surgery.

Alternative Remedies & Self-help

A diet high in protein and vegetables but low in red meat and fat may reduce the risk of prostate enlargement.

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