The Enlarged Prostate

Benign prostatic hyperplasia, or BPH, refers to an enlarged prostate. The condition is considered benign when lab tests have found no cancerous cells. The enlarged gland presses against the urethra as it grows: this prevents the free flow of urine. Urine pools in the bladder, where it irritates the bladder walls and eventually causes the walls to thicken. The bladder becomes so sensitive it contracts in response to small amounts of urine, resulting in frequent urination.

The most common symptoms of BPH are all associated with urination:

Men over the age of forty are at increased risk of developing enlarged prostate symptoms. By age sixty, half of all men display some symptoms. Incidence rates continue to rise with age: ninety percent of men over seventy have BPH symptoms. By age sixty the prostate may have doubled in size, and may double again by age seventy.

Why benign prostatic hyperplasia occurs is unknown. Men who have had their testicles removed do not develop BPH, so it appears that the testicles play a role in prostate growth.

Current medical thinking links BPH to testosterone production. Men produce testosterone and estrogen, a "female" hormone. Testosterone levels drop with age, but estrogen levels remain constant. Proportionally higher levels of estrogen may promote prostate growth.

A second theory suggests that the testosterone-based hormone DHT (dihydrotestosterone) is responsible. The prostate manufactures DHT from testosterone, and levels of DHT appear to build up in the gland even as overall testosterone levels drop with age. The exact connection between DHT and BPH has yet to be determined.

Left untreated, an enlarged prostate can result in a number of complications and health concerns, including:

If bladder damage caused by benign prostatic hyperplasia becomes extensive, treatment may not provide relief. For this reason you should report possible any symptoms to your doctor promptly.