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What Causes Prostate Enlargement?

For many men, prostate growth is a natural part of aging, like wrinkles. Learn about potential causes and risk factors that may increase your chance of developing benign prostate hyperplasia (BPH), the medical term for prostate enlargement.

Does a good night’s sleep seem like a distant dream? The frustrating trips to the bathroom every night may be the first sign of an enlarged prostate. Some other symptoms that you may have an enlarged prostate are:1
  • Trouble starting or stopping a stream of urine
  • Urgency to urinate
  • Weak stream
  • Leaking and dribbling

The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of your penis (urethra) passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.1 

Enlarged Prostate – A Common Condition

When the cells of the prostate gland begin to multiply, the prostate grows. The prostate doubles in size in your teens, and then continues to grow for the rest of your life.2

An enlarged prostate is also called benign prostatic hyperplasia (BPH). The enlarged prostate presses against the urethra and can restrict the flow of urine. BPH affects 50% of men by age 60.3 By age 85, this number grows to 90%.4

BPH is a benign condition. It does not mean you have prostate cancer. But the constant urination issues can hamper your quality of life.5

Possible Causes of Prostate Enlargement 

For many men, prostate growth is a natural part of aging, like wrinkles. What causes prostate enlargement isn’t entirely clear. It might be linked to changes in the balance of sex hormones as men age.1 There is also some research about the role of DHT, a male hormone that helps the prostate grow. Older men seem to have higher levels of DHT. And, the excess DHT may be the reason for prostate cell growth.6

Are you at risk of BPH? 

Some factors that can put you at a higher risk of BPH include:1

  • Aging: BPH rarely affects men younger than 40
  • Family history: You’re more likely to have BPH if a blood relative, such as a father or a brother, has prostate issues
  • Diabetes and heart disease: Studies show that your risk of BPH increases if you live with diabetes or heart disease and if you are taking beta blockers
  • Lifestyle: Obesity is known to increase the risk of BPH

What Can You Do?

Most BPH treatment options aim to reduce the lower urinary symptoms. The best treatment for BPH can be decided with your doctor. They will look at your symptoms and whether there are any other issues.

Treatment options include:7,2

  • Watchful waiting: If your symptoms are mild, watchful waiting may be the best way forward. This means regular monitoring of your symptoms, but no treatment.
  • Lifestyle changes: If your symptoms are mild but uncomfortable, your doctor may suggest taking the natural BPH treatment route. They may suggest lifestyle changes to reduce your BPH symptoms. This may include avoiding caffeine and alcohol or reducing liquid intake before bed. Also, training the bladder to hold urine for longer may also be helpful.2
  • Medications: Your doctor may prescribe medications such as alpha blockers, phosphodiesterase-5 inhibitors, 5-alpha reductase inhibitors or a combination of medications.2 These medications shrink the prostate or reduce symptoms by relaxing the smooth muscles of the prostate and bladder neck to allow better urine flow. However, some medications may have undesirable side effects. These may include a drop in blood pressure, dizziness, fatigue and erectile dysfunction, among other things.8
  • Minimally invasive procedures: If medications fail, your doctor may suggest minimally invasive procedures. One such procedure is Rezūm™ Water Vapor Therapy. This new steam treatment for BPH is not surgery. It can be performed in your doctor’s office or at an outpatient facility without general anesthesia. By using the natural energy stored in water vapor, or steam, Rezūm Therapy can help remove the prostate tissue that is squeezing the urethra.

    During the Rezūm Therapy treatment, sterile water vapor is delivered into the prostate tissue. When the steam contacts the prostate tissue, all the stored energy is released into the tissue, resulting in cell death. As days go by, your body naturally absorbs the treated tissue and shrinks the prostate. Without this extra tissue, your urethra can widen and allow the free flow of urine again.

    Other minimally invasive procedures include transurethral microware therapy (TUMT), Temporarily Implanted Nitinol Device (iTIND) as well as prostatic urethral lift (PUL). 
  • Surgery: If medications and minimally invasive procedures do not give the desired results, then your doctor may recommend surgery.2

Visit this webpage to learn more about treatment options for BPH. If you plan to speak with your doctor about possible enlarged prostate symptoms, you can use this guide to start your discussion. 

References:

  1. Benign Prostatic Hyperplasia (BPH). MayoClinic. https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087. 
  2. Jarvis TR, Chughtai B, Kaplan SA. Testosterone and benign prostatic hyperplasia. Asian J Androl. 2015;17(2):212-6.
  3. Barry M, Roehrborn C. Management of benign prostatic hyperplasia. Ann Rev Med. 1997 Feb;48:177-89.
  4. The Growing Problem of an Enlarged Prostate Gland. Harvard Health Edu. https://www.health.harvard.edu/menshealth/the-growing-problem-of-an-enlarged-prostate-gland.
  5. What Do You Want to Know About Enlarged Prostate? Healthline. https://www.healthline.com/health/enlarged-prostate.
  6. What is Benign Prostatic Hyperplasia (BPH)? UrologyHealth. https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph).
  7. 4 Tips for Coping with an Enlarged Prostate. Harvard Health Edu. https://www.health.harvard.edu/mens-health/4-tips-for-coping-with-an-enlarged-prostate.
  8. Cambio AJ, Evans CP. Outcomes and quality of life issues in the pharmacological management of benign prostatic hyperplasia (BPH). Ther Clin Risk Manag. 2007 Mar;3(1):181-96.

All treatments have inherent and associated risks. The Rezūm System is intended to relieve symptoms, obstructions, and reduce prostate tissue associated with BPH. It is indicated for men ≥ 50 years of age with a prostate volume 30cm3 ≤ 80cm3. The Rezūm System is also indicated for treatment of prostate with hyperplasia of the central zone and/or a median lobe. Potential risks include but are not limited to painful urination (dysuria), blood in the urine (hematuria), blood in the semen (hematospermia), decrease in ejaculatory volume, suspected urinary tract infection (UTI), and urinary frequency, retention or urgency. You should talk with your doctor about benefits and risks before moving forward with any treatment option.
Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.
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