Prostate Enlargement: 8 Signs Every Man Should Know
A Personal Journey
If you’ve noticed changes in your urinary habits recently, you’re not alone. About 90% of men will experience prostate enlargement at some point in their lives.
As a doctor, I see patients with these concerns every day, and I understand it can be uncomfortable to talk about. Let’s understand together what’s happening and when you should seek help.
What is the prostate and why does it enlarge?
The prostate is a small gland, about the size and shape of a walnut, located between the penis and bladder. It surrounds the urethra, the tube that carries urine out of the body.
Its main function is to produce a thick white fluid that mixes with sperm to form semen.
As we age, it’s natural for the prostate to increase in size. This natural growth is called benign prostatic hyperplasia (BPH) or simply benign prostate enlargement.
This process usually begins after age 50 and is an extremely common condition.
A frequent concern among my patients is whether this enlargement is related to prostate cancer. The important part you need to know is: there is no direct relationship between the two.
Having an enlarged prostate does not mean increased risk of developing cancer. However, the symptoms can be similar, which makes it essential to know the differences.
8 Signs of Prostate Enlargement You Should Recognize
1. Increased urinary frequency
Imagine playing video games, cooking, or shopping and needing to interrupt what you’re doing every two hours to go to the bathroom.
When the prostate enlarges, it presses on the urethra, narrowing the flow. This pressure can make the bladder more irritable, contracting more frequently, even when it’s not full.
Result: you go to the bathroom much more often than normal.
2. Sudden urinary urgency
Besides going more frequently, many men experience a sudden and uncontrollable need to urinate. That “I have to go now” feeling that can’t wait.
This inability to hold your urine as before is also related to the mechanism we just explained.
3. Nocturia (waking up at night to urinate)
Let’s understand this together: nocturia is one of the most problematic symptoms of prostate enlargement. Not because it’s dangerous to health, but because of the significant impact on quality of life.
Patients frequently tell me that waking up several times during the night to urinate leads to poor sleep quality, fatigue the next day, irritability, and decreased productivity.
4. Hesitation when starting to urinate
Have you ever stood waiting in the bathroom and it seemed to take a bit longer to start urinating? This is called urinary hesitancy.
Again, this occurs because the urethra is being pressed and narrowed by the enlarged prostate, making the start of urinary flow take longer, even when you’re straining.
5. Weak urinary stream
For the same reason, many men notice that their urinary stream no longer has the strength or trajectory it once did.
The flow may seem diminished, with dribbling or interruptions. It’s like when you squeeze a garden hose – the pressure decreases and the water flow changes.
6. Terminal dribbling
A particularly uncomfortable symptom that many men hesitate to mention is dribbling after finishing urination.
You may notice small leaks in your underwear after using the bathroom. This happens because urine remaining in the urethra begins to leak out later.
There is a technique to help completely empty the urethra that I’ll address soon.
7. Sensation of incomplete bladder emptying
Many patients describe a persistent feeling that there’s still urine in the bladder even after they’ve gone to the bathroom.
This can lead to multiple trips to the bathroom and create anxiety about leaving home or traveling to places where there’s uncertainty about bathroom availability.
8. Acute urinary retention
This is the most concerning symptom and the only one on this list that constitutes a medical emergency.
If you notice you’re unable to urinate at all or only a few drops, accompanied by lower abdominal pain or bloating sensation, seek medical attention immediately.
What’s happening is that your bladder is filling up like a balloon, but there’s a complete blockage preventing urine from exiting.
Just like a balloon that continues to be inflated, the bladder can suffer permanent damage if not treated quickly. We typically treat this as an emergency by inserting a catheter (plastic tube) that passes through the penis to the bladder, draining the accumulated urine.
How to differentiate benign prostate enlargement from prostate cancer?
As a doctor, one of the most common questions I receive is: “How do I know if it’s just normal enlargement or something more serious?”
The truth is that the symptoms can appear very similar, but there are some distinctive signs that we healthcare professionals actively look for.
In theory, most symptoms of benign prostate enlargement occur due to two main factors:
- The narrowing of the urethra, affecting flow
- The bladder reacting to this narrowing, contracting irregularly
Prostate cancer can cause the same narrowing depending on size and location, resulting in virtually identical symptoms. However, there are additional symptoms that would concern me more as a doctor:
Warning signs that require immediate evaluation:
- Blood in semen: Although there are various conditions that can cause this, such as infections or inflammation, the presence of blood in semen in men over 40 should always be investigated to rule out prostate cancer.
- Blood in urine: Similar to blood in semen, there are other possible causes, but it’s essential to check for urinary infection and, if there isn’t one, proceed with more in-depth investigations.
- Systemic symptoms: A set of symptoms we look for when suspecting active cancer in the body includes:
- Unintentional weight loss
- Intense night sweats
- Bone pain in the spine, ribs, chest, or other bones without known cause
In very advanced stages of prostate cancer, some men may develop erectile dysfunction, but this is not a common initial presentation symptom.
What to do if you have these symptoms?
If you’ve identified three or more of these symptoms, it’s time to schedule an appointment with your doctor.
I can assure you that this is a conversation we have routinely, and there’s no reason for embarrassment.
Early diagnosis not only quickly relieves your symptoms but also ensures peace of mind – something that’s priceless when it comes to your health.
The only way to really know if you have benign prostate enlargement or if it could be something more serious is through exams and medical evaluation. Your doctor will perform specific tests to help determine the cause of your symptoms.
Frequently Asked Questions
Is prostate enlargement the same as prostate cancer?
No. Benign prostate enlargement is not cancer and does not increase your risk of developing prostate cancer.
At what age should men start being concerned about prostate health?
Most men begin to experience prostate enlargement after age 50, but it’s good to be aware of your prostate health from age 40 onward.
Can prostate enlargement be prevented?
While you can’t prevent age-related enlargement, maintaining a healthy lifestyle with regular exercise and a balanced diet may help reduce symptoms.
Are there medications that can make urinary retention worse?
Yes. Certain antihistamines, decongestants, antidepressants, and medications for overactive bladder can increase the risk of urinary retention.
How is benign prostate enlargement treated?
Treatment options range from lifestyle changes and medications to minimally invasive procedures and surgery, depending on symptom severity.
When is surgery necessary for an enlarged prostate?
Surgery is typically considered when symptoms are severe, medications aren’t effective, or complications like recurrent urinary retention occur.
Conclusion
Remember: approximately 90% of men will have prostate enlargement at some point in their lives. It’s an extremely common condition that, in most cases, doesn’t pose a threat to life.
However, the symptoms can significantly impact your quality of life and well-being.
If you’re experiencing any of the symptoms described above, especially the warning signs, don’t delay medical consultation. Next time, I’ll explain exactly what to expect during that consultation and which tests are performed to rule out prostate cancer.
Your prostate health is an important part of your overall well-being, and taking care of it is simply one more aspect of a healthy life. Don’t let embarrassment or fear prevent you from seeking help when needed.
Important Information
Individual experiences vary. This presentation provides educational information only and is not intended to replace consultation with healthcare professionals. Always consult qualified medical providers regarding health concerns. No specific outcomes are guaranteed. The information shared is based on available research and documented experiences.