Enlarged Prostate: 5 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Nancy LeBrun on March 6, 2021
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    What Experts Say About Enlarged Prostate
    Enlarged prostate, or BPH (benign prostatic hyperplasia), is very common in men, especially those older than 55. Doctors can help the vast majority of men with the troubling urinary symptoms that can come with an enlarged prostate. Here’s what urologists, the specialists who treat BPH, want you to know.
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    1. “The prostate grows throughout most of a man’s life, but not all enlarged prostates need treatment.”
    “A man’s prostate grows about 1 to 2% a year, but we can’t predict whose prostate is going to cause problems. People can have an extremely large prostate and not necessarily have bothersome symptoms. A more helpful term is lower urinary tract symptoms as a result of BPH—and that’s really what we’re treating. If we treated every man who had an enlarged prostate we’d be overtreating,” says Justin Benabdallah, MD, a urologist with Sibley Memorial Hospital in Washington, D.C.
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    2. “We look at specific symptoms to gauge whether we should consider treatment.”
    “There are symptoms we measure and always ask about. Frequency (going more than every two hours), urgency (not being able to delay urination), decreased force of urinary stream, double urination (you urinate once and then you think ‘I gotta go again’), and nocturia, which is getting up to pass water more than twice a night,” says Kevin McVary, MD, a urologist at Loyola University Medical Center in Maywood, Ill. Deciding to start treatment will depend on how much these symptoms affect your quality of life; it varies from person to person.
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    3. “The biggest misconception I hear is that men have to live with urinary symptoms as they age.”
    Treatment for BPH can include medication, minimally invasive treatments, and traditional surgery. “Men need to be aware that there is an arsenal of choices and some may be more appropriate than others for certain men. Care needs to be individualized—there’s no one size fits all,” says Kellogg Parsons, MD, a urologist at UC San Diego Health. “Prostates are pretty diverse in shape and size and that needs to be taken into account. It may be best that you have a workup to assess your anatomy and tailor what procedure might be best for you,” adds Dr. Benabdallah.
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    4. “If you’re concerned about sexual side effects of BPH treatment, tell us. We have options.”
    BPH does not cause erectile dysfunction, but some of the treatments can. “They should definitely come in and talk to a urologist who can have a frank discussion with them about the treatments that are out there and the potential to minimize those particular side effects,” says Dr. Parsons. “There is a percentage of men who do experience long term erectile issues from certain surgical therapies,” adds Dr. Benabdallah, “but [there are so many treatments] there may be a compromise. Ultimately our goal is to minimize the bother of their urinary symptoms.”
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    5. “If you’re worried BPH may mean you have prostate cancer, come talk to us, because it almost never does.”
    “Urination symptoms are not cancer symptoms. A lot of men come and say, ‘doc I got cancer,’ and you reassure the guy,” says Dr. McVary. “It’s extraordinarily rare. Men can become concerned if they start to have symptoms of prostate enlargement that it’s a sign of cancer, but that is a very, very rare event—it’s almost always simply prostate enlargement,” says Dr. Parsons. BPH and prostate cancer can both elevate your PSA (prostate specific antigen) level, but one does not indicate the other.
Enlarged Prostate: 5 Things Doctors Want You to Know

About The Author

Nancy LeBrun is an Emmy- and Peabody award-winning writer and producer who has been writing about health and wellness for more than five years. She is a member of the Association of Health Care Journalists and the American Society of Journalists and Authors.
  1. Prostate Enlargement (Benign Prostatic Hyperplasia). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia
  2. Enlarged Prostate/Bph. Prostate Conditions Education Council. https://www.prostateconditions.org/about-prostate-conditions/prostate-health-conditions/enlarged-prostate-bph
  3. What is benign prostatic hyperplasia? Urology Care Foundation. https://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)
  4. Enlarged Prostate (Gland). Cedars-Sinai. https://www.cedars-sinai.edu/Patients/Health-Conditions/Enlarged-Prostate-Gland.aspx

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Last Review Date: 2021 Mar 6
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