Symptoms
Definition and symptoms of benign prostate enlargement
Enlarged prostate and its symptoms can be described using many different terms and abbreviations: benign prostatic hyperplasia (BPH), benign prostatic syndrome (BPS) and LUTS (lower urinary tract symptoms).
Clarification of terms relating to an enlarged prostate
The prostate is a male sex organ and resembles a chestnut in its shape and size. It is located directly below the bladder and surrounds the urethra. The organ comprises a connective tissue, muscles and many individual glands, which are stimulated by hormones to produce a secretion that is released together with sperm during ejaculation and ensures its mobility.
![[Translate to English:] Grafik zeigt eine normal große Prostata.](/fileadmin/_processed_/3/b/csm_Harnblase_normale_Prostata_Grafik_Prostata_Normal_Beschriftungen__2__b477520820.png)
Around the age of 40, the prostate, which weighs around 20 grams, starts to grow again in most men. This growth is benign and is called benign prostatic hyperplasia (BPH), a medical term that describes only tissue changes. As the prostate grows steadily, it can narrow the urethra, causing problems with urination.
![[Translate to English:] Grafik zeigt eine vergrößerte Prostata.](/fileadmin/_processed_/7/a/csm_Harnblase_vergroesserte_Prostata_Grafik_Prostata_Vergroessert_Beschriftungen__2__ee311eef5f.png)
If symptoms caused by BPH become noticeable, this is often referred to as benign prostatic syndrome (BPS). The term stands for the interrelation between prostate enlargement, the resulting difficulty in urination and the discomfort at the time of urination.
The abbreviation LUTS (lower urinary tract symptoms) summarises the symptoms of the lower urinary tract.
Typical indications of benign prostatic syndrome
If a man notices the following symptoms, he may have BPH:
- Frequent urination
- Sudden urge to urinate
- Urge to urinate during the night
- Weakened or interrupted urine stream
- Delayed urination
- Incomplete emptying of bladder
- Dribbling
- Burning sensation during urination due to inflammation of the urinary tract
About every second man from the age of 50 is affected by BPH, of which about every third has clinical symptoms. In men over 70, about 80 percent have BPH, and about half of those have clinical symptoms.
Trigger
What are the causes of benign prostate enlargement?
Diagnosis
Diagnosis of benign prostate enlargement
As benign prostate enlargement progresses, the symptoms of benign prostatic syndrome (BPS) worsen over time. Different treatment strategies can be successful at different stages of the disease.
To assess the current stage and the progress of prostate enlargement, doctors often use a standardised questionnaire, the IPSS (International Prostata Symptom Score). The score obtained by answering this questionnaire is an indication of the BPS stage.
The IPSS questionnaire can be used for initial orientation. As is so often the case, the same symptoms can have very different causes. You should therefore absolutely leave the medical evaluation of your IPSS to your doctor.
Further diagnostics usually include an anamnesis (discussion about the patient's medical history), a physical examination, the so-called digital rectal exam (DRE) and a transrectal ultrasound (TRUS) for a detailed visualisation of the prostate. In addition, a urine sample, a blood test and urine stream measurement can provide further important information.
Early diagnosis allows for uncomplicated treatment to prevent or slow down the progression of the symptoms of prostate enlargement.
Treatment
Treatment options for benign prostatic syndrome
BPH should be treated early in order to get symptoms under control and, more importantly, to prevent possible secondary diseases (for example urinary stasis, a bladder/kidney infection, prostatitis or overactive bladder). Treatment is adaptedto the individual symptoms of the man:
- If symptoms are mild, watchful waiting may be an option. However, even if the symptoms are mild, well-tolerated phytotherapy (treatment with herbal prostate drugs) is useful. A change in lifestyle (diet, drinking habits) can also have a positive effect.
- Phytotherapy can be an efficient and well-tolerated treatment option for mild to moderate symptoms. Medication may also be considered if symptoms worsen. Alpha-receptor blockers (alpha blockers) and 5-alpha-reductase inhibitors are available for drug therapy in the case of benign prostate enlargement. Furthermore, combination therapies of alpha-1 blockers and 5-alpha-reductase inhibitors or alpha-1 blockers and muscarinic receptor antagonists can also be used.
- If symptoms are severe, those affected should consult a doctor immediately as treatment is urgently recommended. The doctor will conduct a detailed anamnesis to choose the best possible treatment together with the patient. In addition to drug therapy, minimally invasive therapy or surgery may be considered.
Depending on the symptoms caused by prostate enlargement, some treatment options are more suitable for symptoms in one case than those in another. If benign prostate enlargement is detected in time, this problem can be treated with medication for years. This way, surgery may be avoided or at least delayed under certain circumstances.
Prevention
Important for prevention: taking the changes seriously
The prostate enlarges slowly, so the signs of a benign prostate enlargement come gradually and are not necessarily associated with pain. The affected person does not notice anything at first.
But even when the symptoms become obvious, many men learn to live with them. However, it is not uncommon for this to lead to bladder impairment or necessitate a surgery because prostate enlargement altogether prevents urine from flowing out (urinary retention). Therefore, regular check-ups once a year from the age of 45 are very important. They are painless and uncomplicated. The costs for such check-ups are covered by health insurance.
In addition to preventive check-ups, a healthy and active lifestyle can also help to prevent and improve benign prostatic syndrome in the long term. Here are some recommendations:
- Avoid prolonged sitting and hypothermia.
- Exercise regularly.
- Make sure you eat a balanced diet.
- Drink approx. 1.5 to 2 litres of fluids per day, e.g., mineral water, tea or juice spritzers.
- Avoid excessive alcohol consumption, very cold drinks and strong coffee.
- Make sure you have regular bowel movements.
- Enjoy a fulfilling love life.
Important: listen to your body's warning signals and don't be afraid to see your doctor as soon as symptoms occur or seem to get worse.
Specialist groups
Information on BPS for specialist medical groups
In Germany alone, around 5 million men over the age of 50 suffer from lower urinary tract symptoms (LUTS)caused by benign prostate enlargement. Due to the pathomorphological changes associated with benign prostatic syndrome (BPS), severe micturition disorders can occur, which can be accompanied by pain and often significantly diminished quality of life. BPS manifests itself in differently pronounced complaints for different people, which have to be alleviated to avoid further impairment of the bladder among other things.
Specialist group information
Click here to go to the specialist-group section. Log in there to find out about guideline-compliant treatment options for benign prostatic syndrome.
FAQ
Frequently asked questions about benign prostate enlargement
Benign prostatic syndrome (BPS) occurs when an enlarged prostate leads to noticeable symptoms such as a frequent urge to urinate or discomfort when urinating.
Typical symptoms of an enlarged prostate are: frequent urination, sudden urge to urinate, urge to urinate during the night, weakened or interrupted urine stream, delayed urination, incomplete emptying of the bladder, dribbling or burning when urinating due to inflammation of the urinary tract.
Sometimes the exact causes of benign prostate enlargement are not clear. However, the hormonal changes that come with age are obviously responsible for the growth.
It is assumed that, as with many other diseases, an unhealthy lifestyle (unbalanced diet, lack of exercise, smoking) is not a good starting point for good health.
A standardised questionnaire, the IPSS (International Prostate Symptom Score), is used to assess the current stage and progress of prostate enlargement. The score obtained from answering the questions provides information about the severity of prostate symptoms.
An enlarged prostate caused by ageing is not usually dangerous, but can cause unpleasant symptoms such as difficulty urinating. If left untreated, benign prostate enlargement can lead to serious problems such as urinary retention in its advanced stages.
If the enlarged prostate causes noticeable symptoms, you should start treatment as soon as possible and necessary so that you can go about your everyday life with as little discomfort as possible.
No. Depending on the symptoms of the individual patient, various minimally invasive procedures are also possible to alleviate prostate problems. However, many of these have not yet been sufficiently clinically evaluated or are suitable only for certain patients.
Patients in the early stages of benign prostatic syndrome with mild or moderate symptoms and mild stress may benefit from phytotherapeutics.
No, but as soon as symptoms occur, they can be effectively treated and controlled. Lifestyle changes, medication or surgical interventions can significantly reduce symptoms and improve quality of life.
Certain treatments with medication or minimally invasive procedures can shrink or reduce the size of an enlarged prostate. However, it will not fully return to its original size.