Prostate enlargement, medically known as benign prostatic hyperplasia (BPH), is a benign condition that is common in men as age advances. As the prostate gland enlarges over time, pressure is created on the urinary canal, and this can affect urination functions. Prostate enlargement does not mean cancer; however, because it can lead to similar complaints, it must always be evaluated by a urologist.
It is usually more common after the age of 50, and its frequency increases as age advances. While prostate enlargement follows a course with mild complaints at first, it can seriously affect quality of life over time.
The Most Common Symptoms of Prostate Enlargement
Frequent Urination
It is one of the earliest and most common symptoms of prostate enlargement. The need to go to the toilet increases, especially during the daytime. Because the bladder cannot empty completely, the person feels the need to urinate again at short intervals.
Getting Up Frequently to Urinate at Night (Nocturia)
In a significant proportion of patients, getting up to urinate one or more times throughout the night is seen. This disrupts sleep quality and can cause fatigue during the day.
Difficulty Starting Urination
As the prostate enlarges, it puts pressure on the urinary canal, and the start of urination can be delayed. The patient may have to wait to start urinating.
Weak Urine Flow
A marked decrease in the force of urine flow is seen. The urine comes out thinly and the pressure decreases. This is one of the typical signs of prostate enlargement.
Intermittent Urination
The flow stopping from time to time and starting again during urination is a common symptom. This is associated with an increase in obstruction in the urinary canal.
The Sensation of Incomplete Bladder Emptying
The patient may experience the feeling that the bladder has not emptied completely, even after urinating. This can cause urine to accumulate in the bladder over time.
Urinary Incontinence
In advanced cases, urinary incontinence can be seen due to the pressure on the bladder and loss of control. It can occur especially together with a sudden sense of urgency.
Dribbling During Urination
Dribbling at the end of urination and a prolonged voiding process are common in the advanced stages of prostate enlargement.
What Causes Prostate Enlargement?
Although the exact cause of prostate enlargement is not fully known, the most important factor is aging. Apart from this, hormonal changes, genetic predisposition, lifestyle and some metabolic diseases can also play a role.
How Is Prostate Enlargement Diagnosed?
In the diagnostic process, the patient’s complaints are evaluated in detail and a physical examination is performed. The following tests are usually requested by the urologist:
- PSA (Prostate Specific Antigen) test
- Digital rectal prostate examination
- Urinalysis
- Urinary system ultrasonography
- Uroflowmetry (urine flow test)
- Cystoscopy when necessary
Through these evaluations, the degree of prostate enlargement and its effect on the urinary tract are determined.
How Is Prostate Enlargement Treated?
Treatment is planned according to the severity of the disease, the patient’s age and the level of complaints.
Medication Treatment
It is the most frequently used method in mild and moderate prostate enlargement. Medications that relax the prostate and ease urine flow are used. Some medications can also shrink the prostate volume. Treatment usually requires long-term use.
Lifestyle Changes
Regulating fluid consumption, reducing tea and coffee consumption especially in the evening hours, and limiting alcohol and caffeine can reduce complaints. Regular exercise and weight control are also beneficial.
Surgical Treatments
Surgical methods are applied in patients who do not benefit from medication or who have advanced prostate enlargement.
- TUR-P (closed prostate surgery): It is one of the most frequently applied methods.
- Laser prostate surgeries: These are methods that cause less bleeding and provide fast recovery.
- HoLEP and other endoscopic techniques: These are effective modern surgical options in large prostates.
After surgery, patients are usually discharged within 1 to 3 days and can return to their normal lives in a short time.
Treatment Duration and Recovery
While medication treatment usually continues for a long time, the recovery process after surgical treatment is completed within a few weeks. In the vast majority of patients, a marked improvement in urinary complaints is achieved.
When Should One Consult a Doctor?
It is important to consult a urologist in the following situations:
- If there is marked difficulty urinating
- If you get up frequently to urinate at night
- If urine flow has weakened
- If the bladder does not empty completely
- If urinary incontinence has started
- If the complaints are gradually increasing
Summary
Prostate enlargement is a common condition in men that affects quality of life. However, because it is a benign disease, most patients can be treated successfully. Thanks to early diagnosis and regular follow-up, control can be achieved with medication, and when necessary, a permanent solution can be obtained with modern surgical methods.
