Prostate Disease

What is prostate enlargement/BPH (benign prostatic hyperplasia)?
BPH is a non-cancerous enlargement of the prostate gland, the gland surrounding the urethra (the duct that carries urine from the bladder).  It is thought to be the result of cell growth and hormone changes that are part of the aging process. In fact, about half of all men age 75-plus have some BPH symptoms, including:

Problems getting a urine stream started or stopped completely

• A weak urine stream
• Feeling a frequent need to urinate, even causing one to wake at night
• The sensation that the bladder has not emptied, even after urination

While uncommon, BPH may cause the bladder to become blocked or urine to back up. The latter can lead to bladder infections, stones or kidney damage. 

When prostate enlargement is confirmed—usually through a urine test and/or digital rectal exam—a prostate-specific antigen (PSA) test may be advised to rule out prostate cancer. While prostate cancer and BPH are not connected, they can cause similar symptoms.

A wide range of treatments are now available for BPH, including medication, minimally invasive therapies (including laser and microwave therapies) and—if the symptoms are severe—surgery. One’s age, overall health and prostate size are all factors in determining the best course of action.

Many men experience no early symptoms of prostate cancer and first learn of its presence during a routine physical. When symptoms do occur, they often include:

• The need to urinate frequently, especially at night
• Problems starting the urine flow or holding it back
• A urine flow that is weak or interrupted
• Pain or burning during urination
• Recurring stiffness
• Difficulty achieving erection
• Pain when ejaculating
• Blood in the semen or urine

Consult with your primary care physician or a urologist if you experience any of these symptoms.

Today, a man’s course of treatment for prostate cancer can be highly individualized to obtain the best outcome with the least side effects. Options available include:

• Active surveillance (also known as “watchful waiting”)
• Surgery, which can often be performed with minimally invasive techniques
• Radiation therapy
• Cryotherapy or cryosurgery 
• Hormone therapy
• Chemotherapy