Prostate enlargement

Overview

Prostate enlargement (prostatic hyperplasia) refers to the benign multiplication of the prostate cells, usually as part of the normal ageing process. This can block the flow of urine and irritate the bladder, which causes many symptoms relating to urination (frequent need to urinate, weak urine stream, inability to completely empty the bladder, etc.).

Symptoms

Principle: symptoms are caused by the blocking of the flow of urine and irritation of the bladder muscles

First signs

• Difficulty starting urination
• Weak urine stream or stream that starts and stops (despite straining)
• Dribbling after urination
• Frequent need to urinate, with small amounts of urine (also during the night)
• Urgent need to urinate immediately
• Rarely: pain when urinating

Advanced prostatic hyperplasia

• Incomplete emptying of bladder:
  • Feeling of residual urine, pressure in the lower abdomen, overstretched bladder
  • Constant need to urinate
  • Residual urine promotes urinary stones and chronic urinary tract infections
• Urinary incontinence
• Blood in urine: tears in the overstretched wall of the bladder (reddish urine)
• Urinary retention: inability to urinate, excruciating need to urinate

Complications and consequences

• Widening of the urethra and the renal pelvis
• Chronic/recurring infections
  • Bladder infection/prostate inflammation
  • Pyelitis
• Final stage: kidney failure
• Sepsis
• Groin hernia (caused by frequent strong straining or pushing when urinating)

Causes and treatment

Causes

• Benign increased growth of the prostate
  • Hormonal influence (change in ratio of testosterone to oestrogen)
  • Growth factors
  • Family predisposition
  • Part of the normal process of ageing (frequency increases from the age of 50)
• Urethra is almost completely surrounded by the prostate
  • This blocks the flow of urine

Further treatment by your doctor / in hospital

Possible tests

• Physical examination of the prostate
• Ultrasound (sonography)
• Urine test
• Blood test (PSA level)
• Imaging and measurement of urination process, if necessary

Possible therapies

• Watchful waiting (if there is little suffering)
• Medication (“calming” of bladder muscles, suppression of prostate growth)
• Urinary catheter (acute situation)
• Operation (via urethra or abdominal cavity)
  • Consequence: mostly “dry” ejaculation
  • Seldom, negative impact on erectile function (erectile dysfunction)

What can I do myself?

• Prostate enlargement generally cannot be prevented
• Please note: start taking measures at an early stage
• Avoid the following, if possible:
  • Sitting for a long time
  • Very spicy food, alcohol
  • Constipation, cold
• Sexual activity does not have to be restricted
• Plant-based preparations (e.g. nettle root extract and pumpkin seeds)
• Launch preventive care recommendations for more information

Get a personal Preventive Care Recommendation now.

Household remedies

• Put warm herbal packs (hay flower, linseed) on the lower abdomen
• Cabbage wraps
• Take sitz baths with horsetail and try to empty the bladder
• Warm footbath (add a handful of salt and wood ash)

When to see a doctor?

• Annual prostate check-up, from the age of 50
  • Even if there are no symptoms and after an operation
  • Objective: early diagnosis of prostate cancer
• Reddish urine
• Incontinence
• Emergency: inability to urinate (acute urinary retention)

Synonyms

prostate enlargement, prostatic hyperplasia, benign prostatic hyperplasia, benign prostate syndrome, enlarged prostate