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Enlarged prostate common in older men

  • Story Highlights
  • About 50 percent of men over 50 have prostate enlargement
  • Condition is called BPH, or benign prostatic hyperplasia
  • Symptoms include urinary frequency, decrease in urinary stream
  • Medications can shrink the gland; surgery sometimes necessary
  • Next Article in Health »
By Judy Fortin
CNN
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ATLANTA, Georgia (CNN) -- The prostate gland is an integral part of the male reproductive system. When it's enlarged, men can suffer from myriad symptoms. CNN learned more about the condition from Dr. Jacques Carter of Beth Israel Deaconess Medical Center in Boston, Massachusetts.

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CNN: How common is an enlarged prostate?

Carter: It's fairly common for most men over 50. In fact we even see some cases of men in their 30s and 40s have some degree of what we call BPH or benign prostatic hyperplasia. For men over 50 there is about 50 percent prevalence and that number starts to go up. By the time you get to men in their 80s, nearly 80 percent or more have some degree of BPH.

CNN: What are the symptoms?

Carter: Urinary frequency, having to go every couple of hours, is the biggest complaint. Men will also have problems with the decrease in urinary stream or force of stream, some dribbling. There are millions of men with BPH who have no symptoms at all. Millions more have some symptoms that slowly get better over the course of a year and they require no treatment. It's the people who come in with the symptoms that you actively treat.

CNN: What causes BPH?

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Carter: The gland starts to get large based primarily on age, but also based on some hormonal stimulation and hormone reaction so there is an increase in the effect of testosterone on the prostate. As the gland starts to get large it wraps around the bladder and around the urethra.

CNN: Does BPH ever turn into prostate cancer?

Carter: As a rule we say they are two separate conditions. The reason for the confusion is that prostate cancer and BPH occur in the same age group so there is a lot of commonality. They have some of the same symptoms so a person with prostate cancer can have some obstructive symptoms or some urgency or blood in the urine. BPH is not prostate cancer and should never be thought of in the same light.

CNN: What are some of the medications used to treat symptoms?

Carter: Many people with this huge gland need something to shrink the size, and that's where medicines like Avodart and Proscar come in handy. There are side effects with all of these medications. There is some low blood pressure so you want people to start those at nighttime so that there is less likely that they will have problems. Some can't be taken with other medications.

CNN: Is surgery ever necessary?

Carter: On occasion the symptoms are bad enough that you have significant obstruction. You have people who can't void at all, they are obstructed and they can't go. You have to catheterize them for them to urinate. In almost all those cases when patients get those symptoms they are headed to more invasive procedures.

CNN: Is saw palmetto effective in preventing BPH?

Carter: Some recent data has looked at (saw palmetto) and at least academically, the thought is, saw palmetto is no more effective than placebo in getting rid of prostate symptoms.

CNN: Will lifestyle changes help prevent BPH?

Carter: Data has shown the more fat you have in your diet the more you're likely to have an increase in the size of your prostate. If you have a huge prostate cut back on some of the meats. It might make a difference. E-mail to a friend E-mail to a friend

Judy Fortin is a correspondent with CNN Medical News. Jim Morelli of Accent Health contributed to this report.

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