Prostatism Dr Rob Hicks Dr Rob Hicks outlines the problems that can occur when the prostate gland starts to enlarge.

In this article

What is it? What happens?

Why does it happen? Should I see a doctor?

Many men think that as they get older, they have no choice but to suffer the irritating and embarrassing problems a growing prostate gland brings.

However, they're mistaken. They don't have to spend their nights in and out of the toilet and their days developing a knowledge of local lavatories that betters any tourist guide.

Treatment is available for the most common cause of this problem, the non-cancerous condition benign prostatic hyperplasia (BPH), and it doesn't always involve an operation.

The prostate gland makes the liquid that carries sperm on ejaculation, the semen. It's about the size of a walnut and sits at the base of the bladder around the tube that urine passes through (the urethra).

Once men reach their 40s, their prostate gland starts to enlarge. For some men this doesn't cause any problems, for others it's like putting a kink in a hosepipe and causes difficulties with the flow of urine.

Possible symptoms include:

• difficulty passing urine
• a weak irregular stream
• having to get up throughout the night to pass water
• having to find a loo urgently when out and about
• feeling the bladder isn't empty and continually needing to go to the toilet
• dribbling after passing urine

Men with an enlarged prostate can experience some or all of these symptoms.

Often they find they have to run to the loo urgently, sometimes not making it in time. It may be just an inconvenience for some, but for others it can cause extreme discomfort and take over their lives. Many men become frightened to go out.

Although women don't have a prostate gland many also suffer disturbed sleep or interrupted outings because of their husband's problem.

It's estimated that one in four men in their 50s and one in two men over 60 will be troubled to some degree by enlargement of the prostate gland. However, it's not entirely clear why the prostate enlarges as men get older.

It's important to remember that prostate-related problems aren't something that you have to put up with. There are many treatments available, so seeing your doctor to establish the diagnosis is a good idea.

He or she will examine the prostate gland by feeling it in the back passage and may arrange for blood tests and a scan of the prostate to be performed. The tests you have will depend on what your doctor thinks is appropriate.

If the symptoms are only minor then lifestyle changes, such as eating a low-fat diet with plenty of red tomatoes and soya foods, and cutting down the amount of caffeine and alcohol you drink may be all that's needed.

If your symptoms are more troublesome, your doctor can prescribe effective medication to shrink the size of the prostate and relieve your symptoms.

When symptoms persist despite this treatment, or if the gland is very large, then an operation to reduce its size may be advised.

This article was last medically reviewed by Dr Rob Hicks in January 2007.
First published in April 2001.