The prostate is a gland in the male reproductive tract composed of two lobes, and is enclosed by a thin outer layer. It is approximately the size of a walnut, and is located around the urethra right under the bladder, in front of the rectum. One of its main functions is to produce fluid. This fluid is mixed with the sperm coming from the testicle and creates the semen. The prostate fluid moves into the urethra during sexual orgasm, nourishing and energizing sperm, and makes the vaginal canal a more neutral environment.
The prostate can enlarge with age. It can increase from the size of a walnut to the size of a grapefruit. Doctors call this condition benign prostatic hyperplasia, or enlargement of the prostate gland. This problem is common. It affects more than 50% of men, ages 60-70, and up to 90% of men older than 70. Doctors are uncertain why some men are more susceptible to Benign Prostatic Hyperplasia, or why it affects some men a little and others significantly. However, it may have something to do with varying levels of hormones such as estrogen and testosterone.
Men may first notice symptoms of Benign Prostatic Hyperplasia through urination. They may suffer from urgency and frequent urination, especially at night. They may also notice changes in their urine stream (split stream, weak stream, leaking, difficult to start). Most men who suffer from these urinary symptoms have BPH. However, in rare cases, it may be a sign of something more serious. It's important to discuss symptoms with a doctor and be examined because BPH that is left untreated could result in the backflow of urine, urinary tract infections, kidney problems, bladder stones and other serious conditions.
A doctor can diagnose Benign Prostatic Hyperplasia during a routine physical. A digital rectal examination (DRE) is usually done to manually confirm the size of the prostate. The doctor may perform additional tests as needed, including a urine flow measurement, a bladder ultrasound and/or a urodynamic study.
Upon detecting an enlarged prostate, the doctor may perform blood test of the prostate-specific antigen (PSA) to make sure that the enlarged prostate is not caused by prostate cancer. This test is important for the proper diagnosis of BPH. Depending on the results of the DRE and PSA tests, the doctor may also suggest a biopsy of the prostate gland in order to rule out cancer with certainty.
Depending on the severity, Benign Prostatic Hyperplasia can be monitored to see if it gets worse, or it can be treated proactively with medications or minimally invasive therapies. Often men are embarrassed or uncomfortable with the diagnosis of Benign Prostatic Hyperplasia, but it is extremely common, and easily treatable.