Enlarged Prostate: Causes, Symptoms, Risks

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An enlarged prostate troubles more men than might seem at first. What can we expect from this health problem besides a deterioration in quality of life? Why enlargement occurs, what symptoms it has and other interesting information is offered in the article.

Prostate gland at a glance

The prostate gland, technically called the prostate gland, is located below the bladder and its upper surface is adjacent to the bladder. It is part of the internal reproductive system of the male.

The main role of the prepuce is the production of cloudy secretion, which moistens the urethra and thus allows the movement (mobility) of sperm. The turbid secretion, together with the sex cells of the sperm, form the fluid of the ejaculate.

So, the prostate is an important organ for male fertility. However, due to its position, it also plays an important role in the excretory system.

cross section of a male body, internal organs, bladder, prostate — Left: physiological prostate. Right: enlarged prostate. Localized below the bladder. Bladder (bladder), urine (urine), urethra (urethra). Photo source: Getty Images

Benign enlargement (hyperplasia) of the prostate

Benign Prostatic Hyperplasia (BPH) means that the cause of the enlargement of the gland is not due to abnormal growth of cancerous (malignant) cells.

The cause is a process related to the increasing age of the man. It is a slowly progressive hypertrophy and proliferation (growth/expansion) of prostate tissue cells.

In the medical lingo, this process is called as pathological-anatomical growth and proliferation of stromal and epithelial cells of the prostate part.

The cause is mainly due to older age, the influence of the male sex hormone testosterone, hormonal imbalance and genetic predisposition.

The process of prostate enlargement occurs after about age 30. BHP affects older men with a prevalence of approximately 40% in men in their fifties, with 80% of men in their 80s having benign prostate enlargement.

Prostatic hypertrophy causes pressure on the bladder. The consequence is mainly frequent urination frequency and a weak slower urine stream.

However, an enlarged prostate can also be a symptom of an inflammatory process or the beginning of prostate cancer. Therefore, a regular preventive check-up with a urologist is recommended to rule out and possibly establish an accurate diagnosis.

The cause of the development of benign growth of the prostate gland is not completely clarified. The etiology of hyperplasia has more than one factor, with the greatest role played by advanced age and a change in the level of sex hormones. The risk of developing it increases especially after the age of 40 in men.

The male sex hormone testosterone can change into a more active metabolite dihydrotestosterone, which stimulates its very growth in the cells of the prostate tissue.

Another risk factor is genetic predisposition - family history, hormonal imbalance, inflammatory processes and other diseases of the area. Diabetes mellitus (diabetes), obesity and cardiovascular disease may also play a role.

A risk factor is an unhealthy lifestyle with excessive intake of animal fatty foods, saturated fatty acids, excessive consumption of alcohol, caffeine and smoking tobacco products.

If it is a malignant enlargement of the prostate gland, the cause is an abnormal growth of cells in the lining of the prostate gland, which carries much greater risks and health complications.

It is therefore important to be examined by a urologist who will establish a clear cause for the hyperplasia of the prostate gland and thus exclude the diagnosis of prostate cancer.

By increasing the volume of the gland, there is a subsequent oppression of the surrounding structures. The growing prostate exerts pressure on the bladder from below and on the urethra from both sides.

Thus, the result is a weakened bladder wall and a blocked (narrowed) urethra.

Symptoms of prostatic hyperplasia are primarily divided into irritative and obstructive.

Irritative manifestations are associated with frequent urges to urinate. Conversely, obstructive symptoms are related to a slow urine flow, intermittent urination, and a feeling of incomplete bladder emptying.

The most common manifestations of prostate enlargement:

slow urine flow
feeling of not emptying the bladder
need to urinate frequently
intermittency (not continuous)
nocturia, i.e. waking at night to urinate
urge incontinence (urine leak following a strong sudden need to urinate)
urinary tract infection
erectile dysfunction
pelvic floor dysfunction

Prostate enlargement and pressure on the urinary system can also bring other health complications.

These are bladder inflammation due to incomplete emptying, formation of bladder stones, bladder damage, kidney damage and possible sexual difficulties in the form of erectile dysfunction.

normal and enlarged prostate — Benign (benign) prostatic hyperplasia. Left: physiological prostate size with normal urethral function. Right: enlarged prostate gland with subsequent urethral oppression. Photo source: Getty Images

The main aspect of prostate diagnosis is a per rectum palpation examination with the finger of a urologist through the patient's. The examination provides information about the size, texture and consistency of the prostate gland.

The examination includes history taking - obtaining information about the patient's current difficulties and health problems.

Another basic point of diagnosis is the collection and evaluation of a urine sample, which reveals possible inflammatory processes and bacterial infections. There is also a measurement of the pressure of the urine stream, which is professionally called uroflowmetry.

The urologist, using physical examination ultrasonography, displays the internal soft structures of the excretory system of the patient on the monitor. This instrumental examination is painless and is applied superficially in the region of the patient's lumbar spine.

A blood sample is taken to detect the presence of PSA - prostate specific antigen (an enzyme produced by prostate cells), which is important in distinguishing between malignant and benign prostate enlargement.

However, its presence is also possible in infections, so it may not necessarily be prostate cancer.

A urologist can perform a prostate biopsy - inserting a special biopsy needle through the patient's rectum and taking a sample of prostate tissue. The examination is mainly used to clarifythe causes of growth and at the same time exclude the diagnosis of prostate cancer.

Prevention of prostate health

The prevention of benign growth of the prostate gland, due to increasing age and genetic susceptibility, is not clearly established. However, the stimulus for its growth is multifactorial and can be eliminated to some extent.

The primary prevention of prostate health is a regular preventive check-up with a urologist, especially after the age of 40.

The daily basis of prostate health is an appropriate diet-based lifestyle.

It is recommended to eliminate the intake of fatty foods, saturated fatty acids, animal fat and simple sugar. Beware of excessive consumption of red meat, dairy products or highly processed foods.

However, it is advisable to increase the intake of vegetables, fruits, soy and fibre. Within vegetables, especially foods containing lycopene: tomatoes, carrots, broccoli, spinach and kale. Drinking green tea has beneficial effects on the prostate.

As part of the natural help of herbs, it is possible to reach for teas, tinctures or extracts of herbs aimed at the male and excretory system.

However, it is advisable to consult their intake with a specialist, as an inappropriate choice of herb can affect hormonal (im)balance. Examples of herbs to support the urinary tract and prostate gland are Willowherb, Serenoa creeper or Dwarf Willow.

Movember - Prostate cancer awareness month

There is an internationally recognized awareness month for men's health and prostate prevention called November, nicknamed Movember. Movember is a portmanteau of the Australian-English diminutive word for moustache, "mo", and "November".

The main idea is the importance of preventive checkups for men with a urologist.

The aim of Movember is to raise awareness of the risk of prostate cancer.The moustache as the driving symbol of the movement. The symbol is the colour blue, the beard and the minimalist blue ribbon.

Movember promo — Movember - men's health and prostate cancer risk awareness month. Photo source: Getty Images

Prostate enlargement treatment: monitoring, medications and surgery

Enlarged Prostate is treated by

Urology

Other names

Benign prostatic hyperplasia, BPH

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Men's magazine: erection, fertility, prostate, hormones,

Mgr. Kristína Krajčovičová

Healthcare worker

I completed my bachelor's degree in physiotherapy at the Faculty of Biomedical Engineering of the Czech Technical University in Prague. I continued and completed my master's degree in physiotherapy at the Faculty of Health Engineering of TnUAD. I am currently pursuing my PhD rigorosis at the Slovak University of Health Sciences in Bratislava. During my studies I worked as a physiotherapist in the rehabilitation clinic of Vamed Mediterra in Prague and then as a physiotherapist at the Regional Hospital in Liberec in the Department of Neurology. During my employment I was part of the medical team in the Covid19 department. I am mostly interested in human musculoskeletal system, rehabilitation, physiotherapy in gynaecology and natural medicine. My hobbies include exercising, running, writing and managing social media.

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