The Symptoms of an Enlarged Prostate
It is normal for your prostate gland to become somewhat enlarged as you age. This condition is known as benign prostatic hyperplasia , or BPH.
Your prostate experiences two of growth periods. One happens during puberty, when the prostate doubles in size. The other phase begins about age 25, when the gland begins to grow once again. This growth period often may ultimately result in BPH.
As your prostate expands, a layer of tissue surrounding it prevents it from enlarging, causing the gland force against the urethra. The bladder becomes irritable, and begins to contract even when it is not full, causing more frequent urination. Eventually, the bladder may weaken and lose the ability to completely empty, and some urine will remain in the bladder. This constricting of the urethra and limited voiding of the bladder produce many of the problems associated with BPH.
The symptoms of BPH vary, but the most common ones often begin after the age of 50. Most involve changes or problems with urination, such as
- A weak or hesitant urine stream
- Incontinence (leaking or dribbling)
- Increased frequency of urination, particularly at night
- Trouble beginning a urine stream or only making a dribble
- Sensation that the bladder has not completely emptied
- A strong or sudden urge to urinate
- Stopping and starting again several times
- Pushing or straining to begin
BPH symptoms can ultimately lead to:
- Backflow of urine, which may result in infections of the bladder or kidney
- Complete blockage of urine flow
- Kidney failure
Once the bladder is damaged permanently, BPH treatment may be ineffective. When BPH is diagnosed during its beginning stages, there is less risk of developing more serious complications.
Why BPH Develops
The causes of BPH are not completely understood. No definitive information on potential risk factors exists. It has long been known that BPH occurs mainly in older men and that it does not develop in men whose testes were removed prior to puberty. Because of this, researchers believe that factors related to aging and the testes may spur the development of BPH.
Men produce both the male hormone testosterone and smaller amounts of the female hormone estrogen. As you age, the level of testosterone in your blood decreases, resulting in a higher proportion of estrogen. Animal studies have suggested that BPH may occur due to the higher levels of estrogen within the gland. This increases the activity of certain substances that promote cell growth.
Some research implies that BPH may occur due to a set of instructions given to cells early on in life. According to this theory, BPH develops when cells in one section of the prostate follow these instructions and “reawaken” in the later years of life. These cells can then deliver signals to the other cells in the prostate, sending instructions to grow or making them more receptive to hormones that promote growth. Another new theory is that there is a route that transmits testosterone to the prostate, and this route’s regulator loses its efficiency with age, causing accelerated growth of the prostate gland.
The size of your prostate does not always determine the severity of the symptoms. Many men with significantly enlarged glands have little obstruction and minor symptoms. Others, whose glands are less enlarged, have more severe blockage and more serious symptoms.
You may not be aware of any obstruction until you suddenly find yourself unable to urinate at all. This condition, known as acute urinary retention, can be brought on by over-the-counter allergy or cold medicines. Such decongestant medications contain what are known as sympathomimetics. One potential side effect of this drug is that it can prevent the bladder opening from relaxing and allowing urine to pass. When there is already partial obstruction, acute urinary retention also can be triggered by alcohol, cold temperatures, or long periods of immobility.
Early symptoms of BPH may take many years to become bigger problems. In most cases, these symptoms may point to an enlarged prostate, but they may also be a sign other, more serious conditions that require prompt attention. If you are experiencing these early symptoms, it is a good time to see your doctor.
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