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Prostate Enlargement

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What is it?

Benign prostate enlargement

Normally, the prostate is about the size of a chestnut and weighs 20 to 25 grams. The gland lies below the bladder and surrounds the urethra. With age, the glandular tissue of the prostate grows and it increases in size. As a result, the urethra becomes narrowed and the strength of the urine stream decreases. This cell proliferation is not malignant and initially harmless - not to be confused with prostate cancer - and is therefore also called benign prostate enlargement or benign prostatic hyperplasia (BPH). Nevertheless, symptoms caused by benign prostate enlargement can severely impair the quality of life of those affected and can lead to complications and late effects.


Symptoms and complaints

The increase in size and narrowing of the urethra may cause the following symptoms:

  • Obstructive symptoms (urination problems): Weakening of urinary stream, prolongation of micturition, delayed onset of bladder emptying, post urination dribbling, residual urinary sensation and urinary retention (total urinary retention).
  • Irritative symptoms (bladder urgency symptoms): Frequent urination, nocturnal urination, constant urination, imperative (sudden onset) urination, frequent urination of small amounts (pollakiuria), nocturnal urination

If BPH is not treated, it can lead to significant complications. The bladder is emptied only incompletely due to the mechanical obstruction of the urine outflow and germs form in the residual urine, which in turn cause painful inflammations in the urinary tract and bladder. In the worst case, complete obstruction of the urethra can occur in the advanced stages. Urinary retention, as it is called, is always an emergency that must be treated immediately, otherwise urine may back up into the kidneys with subsequent kidney failure.


Clarification of possible prostate diseases

In order to clarify a possible prostate disease, the urologist performs a number of examinations as part of cancer screening or in the event of complaints. These include a detailed interview, palpation of the prostate, and determination of the PSA value. If there is a benign enlargement of the prostate, an additional urine flow measurement (uroflowmetry) is performed to determine the obstruction of the urine flow and a subsequent ultrasound examination of the bladder to determine the residual urine. A urine sample provides information about concomitant diseases such as inflammation or bleeding of the urinary tract.


Rapid further development of treatment methods

Due to new findings on the development of the disease as well as the rapid further development of medicinal and surgical treatment methods, a very differentiated treatment of benign prostatic hyperplasia is possible today. The goal of therapy should always be to eliminate micturition problems and to eliminate the obstruction to a large extent. The therapeutic options depend on the extent of the obstruction and the intensity of the irritative symptoms. In addition to the objective criteria for the indication, the subjective symptoms and the patient's preferences should always be taken into consideration when selecting the appropriate therapy.


Signs and symptoms of benign prostate enlargement
Late effects and complications
At what point should surgery be performed for benign prostate enlargement?
Prostate Questionnaire (IPSS)