The cause of prostate enlargement is still largely unknown, but it is believed to be linked to hormonal changes that occur as men age. As the body's hormonal balance shifts, it can lead to an increase in the size of the prostate. This is similar to other age-related changes, such as wrinkles. It is not fully understood what causes prostate enlargement, but it may be due to alterations in the levels of sex hormones as men age.
Additionally, research has suggested that a hormone called dihydrotestosterone (DHT) may play a role in prostate growth. Older men tend to have higher levels of DHT. Excess DHT may be responsible for the growth of prostate cells. The balance between estrogen and testosterone in the body also changes with age, which can lead to an enlarged prostate.
Symptoms of benign prostatic hyperplasia (BPH) can also indicate more serious conditions, such as prostate cancer. An enlarged prostate can cause uncomfortable urinary symptoms, such as difficulty urinating or a weak urine stream. Transurethral resection of the prostate (TURP) is the most common surgery for BPH and is considered the gold standard for treating urethral obstruction due to BPH. Finasteride and dutasteride work more slowly than alpha-blockers and are only useful for moderate prostate enlargement. However, further research is needed to determine how we can prevent prostate enlargement.
If symptoms return, additional treatment may be necessary, including BPH. Not all men with an enlarged prostate will experience symptoms. A physical exam and a PSA blood test can help a healthcare provider determine if the prostate is enlarged or tender or if any abnormalities require further testing. Men with risk factors for BPH should talk to their healthcare provider about any lower urinary tract symptoms and about the need for regular prostate exams. Other conditions, such as bladder problems, urinary infections, or prostatitis (inflammation of the prostate), can also cause urinary symptoms. Some studies suggest that obese men and those with diabetes may be more likely to develop an enlarged prostate.
Transurethral incision of the prostate (TUIP) involves making a few small cuts in the prostate to reduce pressure on the urethra. The severity of symptoms in people with an enlarged prostate varies, but they usually worsen over time. More research is needed to understand how to interpret a PSA blood test, its ability to differentiate between cancer and other prostate diseases such as BPH, and what action should be taken if PSA levels are high. Problems can arise when treatments for BPH leave part of the prostate intact.