Complex Health Problem

Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH) and prostatic hypertrophy, prostate gland enlargement can cause bothersome urinary symptoms. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems.

Symptoms: Prostate gland enlargement varies in severity among men and tends to gradually worsen over time. Prostate gland enlargement symptoms include:

· Weak urine stream
· Difficulty starting urination
· Stopping and starting while urinating
· Dribbling at the end of urination
· Frequent or urgent need to urinate
· Increased frequency of urination at night (nocturia)
· Not being able to completely empty the bladder
· Urinary tract infection
· Formation of stones in the bladder
· Reduced kidney function

The size of your prostate doesn’t necessarily mean your symptoms will be worse. Some men with only slightly enlarged prostates have significant symptoms. On the other hand, some men with very enlarged prostates have only minor urinary symptoms.

Causes
Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow. Doctors aren’t sure exactly what causes the prostate to enlarge. It may be due to changes in the balance of sex hormones as men grow older.

Risk Factors: The main risk factors for prostate gland enlargement include:

· Aging. Prostate gland enlargement rarely causes signs and symptoms in men younger than 40. By 55, about 1 in 4 men have some signs and symptoms. By 75, about half of men report some symptoms.

· Family history. Having a blood relative such as a father or brother with prostate problems means you’re more likely to have problems as well.

· Where you’re from. Prostate enlargement is more common in American and Australian men. It’s less common in Chinese, Indian and Japanese men.

Complications
Prostate gland enlargement becomes a serious problem when it severely interferes with your ability to empty your bladder. If this is the case, you’ll probably need surgery. Complications of enlarged prostate include:

· Acute urinary retention. Acute urinary retention is a sudden, painful inability to urinate.

· Urinary tract infections (UTIs). Some men with an enlarged prostate end up having surgery to remove part of the prostate to prevent frequent urinary tract infections.

· Bladder stones. These are mineral deposits that can cause infection, bladder irritation, blood in the urine and obstruction of urine flow and are generally caused by the inability to completely empty the bladder.

· Bladder damage. This occurs when the bladder hasn’t emptied completely over a long period of time. The muscular wall of the bladder stretches and weakens and no longer contracts properly.

· Kidney damage. This is caused by high pressure in the bladder due to urinary retention. This high pressure can directly damage the kidneys or allow bladder infections to reach the kidneys.

When to See a Doctor
If you’re having urinary problems, see your doctor to check whether your symptoms are caused by an enlarged prostate and find out what tests or treatment you may need. If you’re unable to pass urine at all, seek immediate medical attention.

About the U of U Health Care Urology Speciality Clinic
William Brant, M.D., specializes in the diagnosis and treatment of complex urologic reconstruction, urinary incontinence, erectile dysfunction, and sexual health. He has the only specialty clinic of its kind in the Intermountain West. At Dr. Brant’s clinic, men are treated in an anonymous and sensitive environment, receiving care from a professional who specializes in this area of medicine and can offer the latest treatments for these conditions.