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June 1, 2010 | Comments: 2

What to Do About an Enlarged Prostate

By age 60, half of all men have trouble urinating because of an enlarged prostate. By age 70, it’s nine out of ten. Here’s what you can do to reduce symptoms.

A common problem for older men, benign prostatic hyperplasia (BPH) is a noncancerous growth of the prostate. The gland grows slowly as men age, pressing on the bladder, and in some men this enlargement begins to cause symptoms by mid-life.

With BPH, you have more frequent urges to urinate, but then you get a hesitant, weak stream or dribbling. What used to be quick now takes several minutes. You may have trouble getting a solid night’s sleep and may dread being more than a few steps from a toilet or waiting in line for the men’s room. Called “benign” because the enlargement is not cancer nor does it lead to cancer, BPH may not seem so benign if you have it.

Why it happens

No one knows what causes BPH. Some studies have pointed to a connection with being overweight—and losing weight, if you are overweight, may lessen symptoms. Other research suggests that consuming lots of fruits and vegetables may reduce the risk. The normal drop in testosterone levels that comes with aging may have something to do with BPH, but this does not mean that testosterone supplementation will help. Indeed, it might make matters worse.

If you have symptoms, see your doctor. A medical evaluation can determine whether it is BPH or some other condition. No biopsy is needed to diagnose it. If you have mild BPH, it may be manageable with the following measures. If not, there are a variety of medical options.

BPH advice

• Avoid certain OTC cold or allergy drugs and sleep aids. The antihistamines or decongestants in them may worsen symptoms. Review your medications with your doctor or pharmacist.

• Cut down on fluids, especially alcoholic beverages, in the evening to decrease the need to urinate in the night.

• Go easy on caffeinated drinks, which have a mild diuretic effect.

• If you cannot empty your bladder, try sitting when you urinate rather than standing. Running the water can help. Also try “double voiding”: urinate, relax and wait a moment, then resume.

• Be active. Some research suggests that exercise may help reduce symptoms.

• Stay warm. Cold weather can lead to urine retention and increase the urgency to urinate in some people.

• Plan ahead. If you are attending a long meeting or concert, cut down on fluids beforehand. Visit the bathroom in advance.

• Try not to postpone urination to the last minute. An over-distended bladder can make urination more difficult.

• If you feel anxious and depressed by all this, talk it over with your doctor and/or a sympathetic listener. BPH is common and nothing to be ashamed of. Women, too, have problems with urinary urgency and incontinence as they grow older.

• If your symptoms seem unmanageable, discuss medication and, possibly, surgical treatment with your doctor.

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