Talking With Your Doctor About Enlarged Prostate

Medically Reviewed By William C. Lloyd III, MD, FACS
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The prostate is a male sexual organ. It surrounds the urethra, a tube inside the penis that transports urine and semen out of the body. During ejaculation, the urethra has another job: It transports semen, which is a combination of fluid from the prostate and sperm.

A Common Problem

The prostate in an adult male is about the size of a walnut. But as some men get older, their prostate keeps growing. For men older than 50, enlarged prostate, also called benign prostatic hyperplasia (BPH), is a common problem. It occurs when the prostate enlarges to the point in which it squeezes the urethra, which can affect bladder control. BPH can also obstruct the flow of semen.

Men with BPH are likely to experience one or more of the following symptoms:

  • The urgent and frequent need to urinate. You may need to get up several times at night to go to the bathroom.

  • Trouble urinating. Your urine stream may be weak, or you produce just a small amount of urine each time you go.

  • Blood in the urine

  • Leaking urine

  • Feeling like you still have to go after just urinating

BPH isn’t a serious condition unless its symptoms are affecting your quality of life. Some men with BPH don’t experience any symptoms. Still, more than half of men in their 60s and up to 90% in their 70s and 80s have some symptoms of BPH. BPH can lead to other health problems, such as urinary tract infections and, rarely, kidney damage. Some men with prostate cancer also have BPH, but the two aren’t necessarily connected.

The only way to know if you have an enlarged prostate is to see your physician for an exam. Discuss the following with your doctor so you can work together to tailor the best course of action for you.

Your Symptoms

Tell your doctor about any symptoms you’re experiencing. To help your doctor determine the severity of your symptoms, your doctor may ask you to complete a questionnaire, such as the International Prostate Symptom Score.

You’ll answer the following types of questions: During the last month or so, how often have you had to urinate again less than two hours after you finished urinating? You’ll then score your answers from 0 to 5, with zero representing the less severe end of the scale. Your answers will be totaled and rated from mild to severe.

If your doctor suspects BPH, you may be referred to a urologist, a doctor who specializes in problems with the urinary tract and the male reproductive system.

Tests You May Need

To diagnose BPH and rule out other possible health problems, talk with your doctor about tests you may need. Some of the most common include:

Digital rectal exam: This is usually the first test. With a gloved finger, a doctor feels the part of the prostate next to the rectum to get a general idea of the size and condition of the prostate.

Prostate-specific antigen (PSA) blood test: PSA is a protein that prostate cells produce. A PSA blood test can help doctors screen for prostate cancer. The test isn’t foolproof. A high PSA score may indicate prostate cancer, but you can have a high PSA score without having prostate cancer. Your doctor will interpret the results of this test.

Imaging: Your doctor may have you undergo an X-ray or sonogram, which uses sound waves to produce an image of the prostate. Another type of test, an intravenous pyelogram, takes an X-ray of the urinary tract after injecting dye into a vein. The dye helps the prostate show up on the X-ray.

Your Treatment Plan

Depending on your diagnosis and the severity of your symptoms, you may opt to do nothing other than to get regular checkups to keep tabs on your condition. If your symptoms are interfering with your daily routine, medication is available to shrink or relax the prostate so it doesn’t block the bladder.

Nonsurgical and surgical procedures to remove parts of the prostate to relieve urine blockage may also be an option. Work with your doctor to find the best treatment for you. Click through the slideshow 7 Treatment Options for Enlarged Prostate for a quick look at your options.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 1
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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  2. Prostate Enlargement: Benign Prostatic Hyperplasia. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/benign-prostatic-hyperpla...

  3. What I need to know about Prostate Problems. National Institutes of Health. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/prostate-problems/Pages/e...