Q. Does an enlarged prostate require treatment?
A. It’s very common for the prostate to grow larger with age, beginning at around age 40 in some men and affecting nearly all men by the time they reach 80. The condition, also referred to as benign prostatic hyperplasia (BPH), is not a sign of prostate cancer, although the two conditions can occur in the same man.
Tony Luongo, a urologist at Tufts Medical Center, says enlargement isn’t necessarily a medical problem. “A good percentage of men have little to no problems or symptoms associated with enlarged prostate,” he says. But others do experience symptoms, primarily urinary: a more frequent urge to urinate, difficulties emptying the bladder, and pain or even bleeding with urination. Luongo says that severe cases of BPH can lead to bladder stones, dangerous infections, urine retention, or kidney problems.
In most cases, BPH requires treatment only when symptoms interfere with daily activities or sleep. “We treat the symptoms, not the size,” says Richard Babayan, chief of urology at Boston Medical Center. Some people can manage symptoms with lifestyle changes, like restricting fluids before bed, avoiding caffeine and alcohol, and planning frequent bathroom breaks. Medications called alpha-1 blockers can help improve urinary flow. Other medications can shrink the prostate in more severe cases. Prostate surgery may be necessary in cases that don’t respond to medical treatment. Although BPH is not a serious medical problem for most men, Babayan advises seeing a physician if experiencing urinary symptoms to rule out prostate cancer.