There may be no symptoms present with BPH. However, many men do experience symptoms with an enlarged prostate. The most common are a weak stream of urine, a frequent and urgent need to urinate, an inability to empty the bladder thoroughly, urine leakage, and urine retention.
An enlarged prostate diagnosis typically involves these methods:
Digital rectal exam – manual check for increased size of prostate
Urinalysis – determines any infections present
Urine flow study
PSA blood test
Transrectal ultrasound – does double duty allowing view of prostate and check for prostate cancer
Cystoscopy – determines prostate size and obstruction level
No treatment can be predetermined as the progression of BPH is different for every man. Treatment options for an enlarged prostate vary widely depending on the individual patient. Symptoms may remain stable for years, and some studies show improvement in one third of men diagnosed with BPH. Men experiencing moderate or more severe BPH symptoms should consult with their physician to weigh the factors and conditions present to help determine the course and nature of BPH treatment.
Factors considered when determining the best possible treatment include:
Age of the patient
Prostate size and rate of tissue growth
Overall condition and health of the patient
Amount of pain or discomfort the patient is experiencing
Watchful waiting is a term referring to taking no medical action while monitoring the patient’s condition at least once a year. Dietary changes and exercise during this time can allow indefinitely postponing any need for further medical intervention. Conversely, the same man who is obese, sedentary, and eats a high fat diet, is three times as likely to need further medical intervention as other men.
Medications such as alpha blockers may manage BPH symptoms. Alpha reductase inhibitors may slow tissue growth or shrink the prostate. Medications must be taken long term, usually for the remainder of the man’s life.
If surgical intervention is necessary, there are several options:
Prostatic urethral lift is a minimally invasive in-office procedure providing symptom relief with few side effects.
Transurethral resection of the prostate takes place under general anesthesia; the prostate tissue is trimmed and removed.
Laser transurethral resection of the prostate, a less invasive version of a traditional transurethral resection, or Thermo transurethral resection that is even less invasive, using micro, radio, or other waves to destroy excess prostate tissue.
Open prostatectomy – the most invasive surgical procedure is used when most or all of the prostate tissues need to be removed.