The prostate gland is an organ that surrounds the urinary urethra in men. It secretes fluid that mixes with sperm to make semen. The urethra carries urine from the bladder and sperm from the testes to the penis.²
It is about the size of a walnut and weighs about an ounce. The prostate is below the bladder and in front of the rectum.²
The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man’s life. As men age, the prostate may get larger. Benign prostatic hyperplasia often occurs with the second growth phase.³
The prostate on average weighs 20 grams in normal 21- to 30-year-old men, and the weight changes little thereafter unless the man develops BPH. The prevalence of histologically diagnosed prostatic hyperplasia increases from 8 percent in men aged 31 to 40, to 40 to 50 percent in men aged 51 to 60, to over 80 percent in men older than age 80.³
Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a histologic diagnosis characterized by proliferation of the cellular elements of the prostate. Chronic bladder outlet obstruction (BOO) secondary to BPH may lead to urinary retention, renal insufficiency, recurrent urinary tract infections, gross hematuria, and bladder calculi.
BPH is a common problem that affects the quality of life in approximately one third of men older than 50 years. BPH is histologically evident in up to 90% of men by age 85 years. As many as 14 million men in the United States have symptoms of BPH. Worldwide, approximately 30 million men have symptoms related to BPH.6,7
The prevalence of BPH in white and African-American men is similar. However, BPH tends to be more severe and progressive in African-American men, possibly because of the higher testosterone levels, 5-alpha-reductase activity, androgen receptor expression, and growth factor activity in this population. The increased activity leads to an increased rate of prostatic hyperplasia and subsequent enlargement and its sequelae.6,7
The symptoms of BPH may involve problems emptying the bladder or problems with bladder storage.
Symptoms related to bladder emptying include:
- Difficulty starting urine stream (hesitancy and straining)
- Decreased strength of the urine stream (weak flow)
- Dribbling after urination
- Feeling that the bladder is not completely empty
- An urge to urinate again soon after urinating
- Pain during urination (dysuria).
Symptoms related to bladder storage include:
- Waking at night to urinate (nocturia)
- Frequent urination
- A sudden, uncontrollable urge to urinate
Causes and Risk Factor.5
It isn’t entirely clear what causes the prostate to enlarge. However, it might be due to changes in the balance of sex hormones as men grow older.
There are some risk factors for prostate gland enlargement, such as5 :
- Aging. About one-third of men experience moderate to severe BPH symptoms by age 60, and about half do so by age 80.
- Family history. Having a blood relative, such as a father or brother, with prostate problems.
- Ethnic background. Prostate enlargement is less common in Asian men than in white and black men.
- Diabetes and heart disease. Studies show that diabetes, as well as heart disease and use of beta blockers, might increase the risk of BPH.
- Lifestyle. Obesity increases the risk of BPH, while exercise can lower the risk.
- Anon. What are the symptoms of BPH? Available from: http://www.spine-health.com/conditions/lower-back-pain. Accessed at September 14, 2015.
- Anon. Benign Prostate Hyperplasia Available from: http://www.spine-health.com/conditions/lower-back-pain. Accessed at September 14, 2015.
- Cunningham GR, Kadmon D. Epidemiology and pathogenesis of benign prostatic hyperplasia Available from: http://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-benign-prostatic-hyperplasia. Accessed at September 14, 2015.
- Anon. Prostate Enlargement/BPH Health Center. Available from: http://www.spine-health.com/conditions/lower-back-pain. Accessed at September 14, 2015.
- 5. Disease and Conditions: Benign Prostatic Hyperplasia. Available from: http://www.spine-health.com/conditions/lower-back-pain. Accessed at September 14, 2015.
- McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. J Urol. 2011 Mar 17.
- Seftel AD, Rosen RC, Rosenberg MT, Sadovsky R. Benign prostatic hyperplasia evaluation, treatment and association with sexual dysfunction: practice patterns according to physician specialty. Int J Clin Pract. 2008 Apr. 62(4):614-22.