Enlarged prostate is a common medical condition that affects men as they age. It is also known as Benign Prostatic Hyperplasia (BPH). Nearly 50 percent of men between the age 51-60 have enlarged prostate. This percentage increased to almost 80 percent in males who are more than 70 years of age. BPH is quite common and almost 8 out of 10 men develop an enlarged prostate with age.

What is the prostate?

• The prostate is a walnut-sized gland situated below the urinary bladder and near the rectum in males.
• It is a part of the male reproductive system.
• The prostate gland plays a vital role in sexual reproduction.
• It produces a fluid which nourishes the sperms and helps in their transportation via. the  urethra during ejaculation.
• The prostate gland is made up of glandular and connective tissues.

What causes an enlarged prostate?

• As men age, the prostate gets larger. However, the exact cause is unknown.
• The enlargement is mainly linked to a decline in the levels of testosterone, the male sex hormone.
• The cells of the prostate gland proliferate resulting in its enlargement.
• In some men, the enlargement is only slightly larger than normal.
• However, in some men, a great enlargement of the prostate is seen.
• While enlarged prostate is a benign condition, i.e. it has nothing to do with cancer.
• But, it can make urination and ejaculation difficult in men.
• As the prostate enlarges, it presses against the urethra and obstructs the normal urine flow and the release of semen during ejaculation.

Initiation of prostate enlargement

• Generally, prostate enlargement begins when a person is 25 years of age.
• However, the person may not experience the symptoms before the age of 40-45.
• When the age of men increases to 60 years or more, the chances of experiencing symptoms increase to 50 percent.
• As the age increases to 70-80 years, the symptoms become more visible.

Symptoms of prostate enlargement

Here are some of the symptoms or warning signs that one needs to look for in case of an enlarged prostate.

• Difficulty in urinating
• Sudden or urgent need to urination
• Frequent urination, especially at night
• Pain or discomfort when urinating
• Slow or weak urine stream (flow)
• incomplete  emptying of the urinary bladder
• Increase in the urge to urinate

Risk factors for prostate enlargement

Here are some of the risk factors that will increase the chances of prostate enlargement in men.

Ageing

The chances of occurrence of BPH greatly increases with Increase in age, especially after 40 years and above.

Family history

If there is a family history of BPH or prostate problems, the chances will be higher.

Lifestyle and diet

Obesity, lack of physical exercise, and an unhealthy diet further increases the risk for BPH.

Health conditions

Certain medical conditions like diabetes, cardiovascular disease, high blood pressure, insulin resistance, and low HDL cholesterol may contribute towards enlarged prostate.

Diagnosis of enlarged prostate

An enlarged prostate can be diagnosed by a doctor using the following:

• Digital rectal examination
• Prostate-specific antigen (PSA) blood test
• Urine tests such as urinalysis, uroflowmetry, post-void residual volume (PVR), etc.
• CT scan, MRI, ultrasound, and cystoscopy

Treatment of enlarged prostate

The way a doctor handles the BPH condition depends upon the severity of symptoms, age, and other factors. The possible treatment of enlarged prostate may include:

Careful monitoring

Generally, enlarged prostate problem requires active and watchful monitoring by a urologist.

This is ideal for men who are experiencing mild symptoms.

Medication

• Prescription drugs (medications) may also be advised by doctors for treatment of enlarged prostate in case a person is bothered by the symptoms and effects of enlarged prostate.
• The most commonly recommended medicines for treatment of enlarged prostate are Alfuzosin 10mg and Flotral. 
• These are alpha-blockers that work by relaxing the muscles around the bladder exit and prostate gland so that urine can be passed more easily.
• In addition to alpha blocking drugs, the doctors may recommend 5-alpha reductase inhibitors as well. This class of drugs blocks dihydrotestosterone (DHT), a male hormone, whose build-up may cause prostate growth and enlargement.

Surgery

• If the symptoms become severe or medicines fail to provide relief, doctors recommend surgery to remove the prostate tissue.
• Transurethral resection of the prostate (TURP) which is the most common.
• Transurethral incision of the prostate (TUIP) or open prostatectomy may also be advised for patients.

Minimally invasive surgical procedures

• With the advancements in medical science, several minimally invasive procedures are available for treatment of enlarged prostate.
• These include prostatic urethral lift, holmium laser enucleation of the prostate, water vapor thermal therapy, transurethral resection of the prostate, and others.

Prevention

There is no sure way of preventing enlargement of the prostate. However, following a healthy and active lifestyle can reduce the risks.

• Regular exercise and engagement in physical activities
• Eating a balanced and healthy diet rich in fruits and vegetables
• Limiting the intake of caffeine and alcohol
• Adopting healthy lifestyle habits
• Avoiding intake of junk food
• Managing stress through yoga and meditation

Prostate enlargement is a common chronic medical condition seen in men. It tends to worsen with age. However, the use of medications such as Alfuzosin 10 mg and Flotral can help provide relief from the discomfort. Other drugs can stop the prostate growth and even reduce it. Men who are above 50 years old need to take care of their prostate health. Although the condition cannot be prevented, taking certain proactive steps can help manage it effectively whenever it occurs.