Enlarged Prostate: Benign Prostatic Hyperplasia

Nobody knows why prostate glands decide to start growing as men hit middle age, but they do, frequently causing unjustified anxiety amongst its victims, who suspect that such an enlargement must be malignant. This simple, commonplace form of enlargement may be caused by a change in hormones in the prostate. It is a condition doctors call benign prostatic hyperplasia, or BPH for short.

After a certain age most men have signs of it. Studies show that less than 5 per cent of men under 40 have BPH. That number rises to about 50 per cent of men over age 60; by the age of 85 the odds hit 90 per cent. You may have BPH and not even know it.

The prostate is part gland and part muscle, surrounding the base of the urethra (urine tube) where it leaves the bladder. Normally, it is about the size of a walnut, hence the name 'the worrisome walnut', with the point downwards, and consists of three lobes - right, left and median.

If the middle lobe enlarges, it projects into the bladder and so it is the most likely element to obstruct the flow of urine. It may act like a valve over the exit from the bladder, so that the more you strain, the more firmly the outlet is blocked. In addition, because the first section of the urethra actually runs through the prostate gland, such compression means that the flow of urine is slow and weak. As a result, the bladder will not be emptied properly.

Often, however, a swelling prostate will begin to squeeze the urethra, causing problems with urination. These can include a feeling that you need to pee all the time (trips to the bathroom three or four times a night are not uncommon); feeling as if you haven't completely emptied your bladder; feeling that you need to forcibly push the urine out; feeling as though you want to pee but can't get started; and dribbling at the end of urination.