Enlarged prostate - what to ask your doctor
What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ask your doctor
The prostate gland often grows larger as men get older. This is called benign prostatic hyperplasia (BPH). An enlarged prostate may cause you problems with urinating.
Below are some questions you may want to ask your health care provider about your prostate.
Not every man will have to deal with age-related issues like balding or weight gain. Whether you have these problems really depends on your health, and luck. But one problem just about every man will have to face, if he lives long enough, is an enlarged prostate. Let's talk about an enlarged prostate, also known as benign prostatic hyperplasia, or BPH. The prostate gland is part of your reproductive system, and its job is to add fluid to the sperm before ejaculation. The prostate is pretty small when you're young, but as you get older it grows and grows. Keep in mind, this growth isn't cancerous. But by design, the prostate is wrapped around the urethra, the tube that carries urine from your bladder out of your body. So as the prostate grows, it can begin to squeeze or pinch the urethra which often can make it harder for men with an enlarged prostate to urinate. If you have an enlarged prostate, the first notice that you're having trouble urinating. Instead of having a strong even flow, the urine only dribbles out like a leaky faucet; drip, drip, dribble, drip. Because you're not emptying your bladder fully each time, you keep feeling the urge to use the bathroom, even in the middle of the night. To check your prostate, your doctor or urologist will check your prostate gland by inserting a lubricated, gloved finger and feeling for any growth. Other tests may check your urine flow, and how much urine is left in your bladder after you go, as well as look for signs of an infection or prostate cancer. How is an enlarged prostate treated? Treatment often depends on how you feel. If you're not having any symptoms, your doctor may suggest just watching it, that's called watchful waiting. If you've got bothersome symptoms, medications can reduce the size of the prostate gland, and relax your bladder and prostate so you don't constantly feel the urge to go. For more serious symptoms, surgery can remove the extra prostate tissue. To help relieve the symptoms of an enlarged prostate, watch how much fluid you drink, especially before bedtime, or before going out. Minimize alcohol and caffeine, as well as over-the-counter decongestants and antihistamines. They can make your symptoms worse. Double voiding can help. After you've emptied your bladder, wait a moment and try to go again without straining or pushing. Some people take herbs like saw palmetto for an enlarged prostate. Although there's some evidence that these herbs can relieve BPH symptoms, many studies haven't found a benefit. Talk to your doctor before taking any herbal remedy, because they can cause side effects. Prostate enlargement isn't usually serious, but it can have a serious impact on your way of life, especially when you're always going to the bathroom. Remember that BPH is treatable. Work with your doctor to find the treatment that works best for you. If you've been caring for your symptoms for 2 months and not finding any relief, or you're having more serious symptoms like you're not urinating at all, or you have a fever or pain in your back or abdomen, call your doctor as soon as possible.
What is the prostate gland?
Where is it in my body?
What does the prostate gland do?
What causes the prostate gland to enlarge?
Do many other men have prostate problems?
How do I know my problem is not prostate cancer?
What are the symptoms of an enlarged prostate?
Will these symptoms get worse? How quickly?
Can any of these symptoms be harmful or dangerous?
What tests should I have?
How can I treat my symptoms at home?
Is it OK to drink alcohol? How about coffee and other drinks with caffeine?
How much fluid should I drink during the day?
Are there medicines that may make my symptoms worse?
Are there exercises that can help with my symptoms?
What can I do so that I do not wake up at night as much?
I have heard there are different herbs and supplements that may improve my symptoms? Is this true? Are these herbs or supplements safe to use?
What medicines may help?
Are there different types? How are they different?
Will they make my symptoms go away completely?
Does their benefit wear off over time?
What side effects should I look for?
What should I do if I am having a hard time urinating?
Questions to ask when thinking about having surgery for an enlarged prostate:
- Have I tried all the different safe treatments and medicines that may help?
- How quickly will my symptoms get worse if I do not have surgery?
- What are the serious medical problems that can happen if I do not have surgery?
- If I do not have surgery now, does that make having surgery later less effective or more dangerous?
What are the different types of surgery that I can have?
- Are there surgeries that are better for my situation?
- Will I ever need another surgery for a large prostate? Does one kind of surgery help for longer?
- What are the side effects of the different surgeries? Is one surgery more likely to cause problems with erections? With urinary incontinence? With ejaculation?
- Do I need to stay in the hospital after the surgeries? How long will it take to recover?
- Is there anything I can do before surgery to make recovery easier?
Capogrosso P, Salonia A, Montorsi F. Evaluation and nonsurgical management of benign prostatic hyperplasia. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 145.
Moul JW. Benign prostatic hyperplasia. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier 2023:1177-1180.
Terrone C, Billia M. Medical aspects of the treatment of LUTS/BPH: combination therapies. In: Morgia G, ed. Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia. Cambridge, MA: Elsevier Academic Press; 2018:chap 11.
Last reviewed on: 4/1/2023
Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.