Causes of enlarged prostate

Medically Reviewed by Dr Sravya, MBBS, MS

Introduction

The actual causes of enlarged prostate or benign prostatic hyperplasia (BPH) are still unknown. Did you know that all men over 40 years of age undergo some amount of growth in the prostate gland? Enlarged prostate is an age-related condition seen in some men. The prostate is a small accessory gland the size of a walnut and is a part of the male reproductive system. This gland produces some of the fluid that carries sperm during ejaculation as part of the male sexual response. It is located below the urinary bladder and surrounds the urethra, a tube that drains urine.

As the name suggests, it means the prostate gland grows bigger as the age passes, pressing against the urethra and causing difficulties in urinating and other associated complications. This condition is not a risk factor for cancer or a precursor to cancer. Now, here, let’s see in depth about the benign prostatic hyperplasia causes, diagnosis, treatment as well and prevention.

Table of Contents

What do you mean by an enlarged prostate gland or benign prostatic hyperplasia?

To understand the causes of an enlarged prostate gland, it’s vital to know about the prostate gland functions and its adjacent structures. Benign enlargement prostate adenofibromyomatous hyperplasia benign prostatic hypertrophy or benign prostatic obstruction is an age-related condition occurring when the non-cancerous prostate cells start to grow abnormally. This will begin to squeeze the urethra and often makes it harder for men to urinate. This obstruction further leads to other complications such as urinary tract infections, kidney or bladder stones and so on.

The prostate is an accessory gland that produces some fluid that forms the substance that is emitted during ejaculation called semen. This fluid is alkaline in nature which helps to neutralize the acidity in the vaginal canal and prolongs the lifespan of sperm. The prostate has two main growth periods in men as they age. One occurs at the time of puberty when they double in size. The other period begins around 25 years of age and continues to grow gradually as they age. It becomes a problem only until it’s large enough to pinch the urethra, leading to one complication to another.

What are the causes of an enlarged prostate gland?

What causes prostate enlargement is still unknown. It is found to have more likelihood of having it as you get older. 90 per cent of men over 80 years old have this condition.

The hormones produced in the bodies are very powerful enough to cause a wide range of effects on our cells and organs. According to researchers, the causes of prostate gland enlargement are stated as some theories. One theory suggests that anyone with a prostate, when he gets older, increases the production of a hormone called dihydrotestosterone, which stimulates the growth of the prostate gland. Another theory says estrogen and testosterone play a vital role in prostate gland enlargement. At a young age, men produce more testosterone and small amounts of estrogen. But when they get older, the testosterone levels decrease, and there will be more estrogen in the body. This relative increase in the proportion of estrogen stimulates the growth of the prostate gland, leading to prostate gland enlargement.

It is also noticed that men who have undergone the removal of testicles do not develop benign prostatic hyperplasia. Also, the removal of testicles after the development of prostate enlargement causes the prostate to shrink in size.

You may have a greater risk for benign prostatic hyperplasia in the following conditions:

Family history: If you are a person whose father or brother has an enlarged prostate, then you have a higher chance of getting the condition.
Age: Your prostate will gradually grow from the age of 25 until the age of 40. This might not affect you in any way.
Ethnicity: Studies show that black and white men are more susceptible than Asians. Black men may even get symptoms at a very young age.
Medication: The use of beta blockers, which are commonly used to treat conditions like high blood pressure and migraines, can increase the risk for BPH.
Some health conditions can also increase the chance and can be the cause of an enlarged prostate gland. These conditions such as:
-Diabetes
-Heart disease
-Erectile dysfunction
-Obesity

What are the signs and symptoms of an enlarged prostate or benign prostatic hyperplasia?

There are many symptoms shown by people with an enlarged prostate gland. Most of them are related to problems in urinating and bladder and kidney problems. Benign prostatic hyperplasia causes the following

Difficulty in urinating or urinary retention
When you finish your pee, it starts dribbling.
Unable to empty the bladder
Unable to empty the bladder
Strong and sudden urge to pee
Need to urinate more then 2 times in night
Need to urinate more then 8 times a day
Delayed and slowed in starting to pee
A weak urine stream is noticed; that is when your pee stops in between and starts again.

You might need to visit your physician suddenly if the following symptoms are experienced:

How to diagnose the enlarged prostate or benign prostatic hyperplasia?

The condition is diagnosed after a detailed medical history, examination, certain tests, and scans.

Your physician will get your medical history regarding the medication you take and your existing medical conditions. Some conditions and medications can make the BPH symptoms worse.
After the medical history, your physician will examine you. The examination may include a digital rectal scan of the prostate. Here the physician will check if your prostate is large, tender, or irregular by inserting a gloved finger into the rectum. To confirm the diagnosis, other tests are done, such as :
-Urinalysis: Here, your urine sample is collected and checked for blood and bacteria.
-Urodynamic test: In this test, your urinary bladder will be filled with liquid through a catheter to measure the bladder’s pressure during urination.
-Prostate-specific antigen test: This test is done to check for cancer of the prostate gland.
-Post-void residual test: This is done to check the amount of urine left in the bladder after you urinate.
-Cystoscopy: This is the examination done to see any changes in the urethra and bladder. A tiny lighted scope is inserted through the urethra for this examination.

What are the treatment options for an enlarged prostate?

There are various treatments available for enlarged prostate. The treatment will depend on your symptoms, health conditions, age, and the size of the prostate. Your doctor may suggest lifestyle changes, medication, or even surgery, depending on your condition.

Lifestyle changes are usually suggested if you have mild symptoms. Some lifestyle changes may help you in resolving the symptoms.

A single medication or a combination of medications can help you if you have mild to moderate symptoms related to an enlarged prostate. These medications work by

When the medication doesn’t work, many other types of procedures are available to help you improve the moderate to severe symptoms of BPH. In those procedures, an instrument is inserted into the urethra to :

When other treatments haven’t helped, or other complications have occurred, surgery is the final option, which may be helpful when symptoms are severe. Different surgeries usually performed are to:

Can you prevent enlarged prostate or benign prostatic hyperplasia?

The simple answer to the question is no, you cannot prevent an enlarged prostate as it is an age-related condition. The prostate gland will grow in size gradually in every man. Maintaining a healthy weight, decreasing the fluid intake before bedtime, decreasing the consumption of alcohol and caffeinated drinks, taking a balanced diet to avoid excess calories, and being physically active will be some good steps for a healthy prostate. Lifestyle alone cannot prevent benign prostatic hyperplasia. People who have enlarged and don’t want to go for conventional medication and surgery to reduce the symptoms can follow lifestyle changes, which might help them in some ways.