Enlarged Prostate

Enlarged Prostate (Benign prostatic hypertrophy) means that the prostate has enlarged (or hypertrophied) and that the enlargement is benign (that is, not cancerous). It occurs in most men over the age of 40, for reasons that are unclear. The prostate contains fibrous tissue, glands and smooth muscles, all of which can enlarge. If the glandular tissue enlarges it may press on the urethra, the tube that carries urine from the bladder to the outside, and cause symptoms of obstruction - there is nocturia (you need to get up at night more than once to urinate), hesitancy (difficulty in starting urination), a poor stream, and dribbling after urination. If the smooth muscle hypertrophies it fails to relax when the bladder contracts, causing similar urinary difficulties, including failure of the bladder to empty completely, leaving residual urine which may become infected.

In extreme cases of benign prostatic hypertrophy there may be complete urinary obstruction and retention of urine. Rarely this goes on to become chronic, with overflow incontinence were there is intermittent dribbling of urine. This may produce kidney damage as a result of the increased pressure being passed back up the ureters, the tubes between the kidneys and the bladder.

Since the symptoms may also be those of cancer of the prostate, this must be excluded by rectal examination of the prostate, possibly ultrasound and biopsy, and blood tests. Mild degrees of benign prostatic hypertrophy may be helped by agents which relax the smooth muscle cells, and others which act to reduce the size of the prostate. Those with more severe symptoms may require surgery either to remove the overgrown tissue or to reduce the tone of the muscle of the bladder neck
 
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