Benign prostatic hyperplasia, also called an enlarged prostate, is incredibly common, especially among men over 40. While it's not the same as prostate cancer, an enlarged prostate can cause significant quality of life issues.

Dr. Scott Cheney, a Mayo Clinic urologist, says there are ways to treat it and reduce the symptoms, including some lifestyle changes.

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"I like to tell patients that the prostate is kind of like an orange with a straw going right through the middle of it. And as we age, the prostate gets larger and larger. And the straw going through the middle gets compressed by the tissue of the prostate, makes it harder for the bladder to push urine through the urethra," says Dr. Cheney.

Enlarged prostate symptoms can include frequent or urgent urination, a weak urine stream and the inability to empty your bladder.

"I see men who get up at night to pee, and they get up again and again. They get poor sleep, It can really affect their lifestyle. So they're always looking for a restroom wherever they go, they can't drive long distances because they have to stop and urinate very frequently," says Dr. Cheney.

If you suffer from any of those symptoms, Dr. Cheney first recommends a few lifestyle modifications.

"You can tell a man to avoid excess fluids. Some men, they don't realize how much fluid they're drinking. The more fluid you drink, the more often you're going to have to urinate. The types of fluids also matter. So, if a man is drinking a lot of caffeine, a lot of alcohol, especially before bed, that can cause nighttime issues with urination," Dr. Cheney says.

He says talk to your healthcare team about your concerns. An enlarged prostate also can be treated effectively with medications or procedures.

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"I like to tell patients that the prostate is kind of like an orange with a straw going right through the middle of it. And as we age, the prostate gets larger and larger, and the urethra gets compressed by the tissue of the prostate. This makes it more difficult for the bladder to push urine through the urethra, making it harder to empty the bladder," says Dr. Cheney.

Watch: Dr. Scott Cheney talks about benign prostatic hyperplasia or enlarged prostate

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The prostate, situated just below the bladder, surrounds the upper part of the urethra — the tube responsible for draining urine from the bladder. The prostate's primary function is to facilitate the reproductive process and fertilization.

Enlargement of the prostate gland can give rise to uncomfortable urinary symptoms, including the obstruction of urine flow from the bladder, causing individuals to strain more to urinate.

Dr. Cheney says prostate enlargement, or BPH, does not mean cancer. "It is truly just enlargement, and the cells in the prostate are not cancerous. Prostate enlargement is much more common than prostate cancer," he says.

An enlarged prostate can cause troublesome symptoms and affect the quality of a person's life.

"It's a big quality of life issue for men," says Dr. Cheney. "I think a lot of men ignore their symptoms for a long time because we don't like to complain or think it is a normal part of aging. But, in reality, it's so common, and there are multiple ways that we can treat prostate enlargement and symptoms associated with it."

Symptoms of an enlarged prostate include:

• Frequent or urgent need to urinate.
• Urinating more often at night.
• Trouble starting to urinate.
• Weak urine stream, or a stream that stops and starts.
• Dribbling at the end of urination.
• Not being able to empty the bladder fully.

"Treatment can be something as simple as taking a well-tolerated medication that helps to open that channel through the prostate that can relieve symptoms, all the way up to surgery where we remove the obstructing tissue of the prostate to leave men with a more wide-open channel and better emptying," he says.

Treatment options

"Here's how I like to think about treatment of prostate enlargement. The first thing that you can do is lifestyle modifications, which takes no medicine and is low risk. You can tell a man to avoid excess fluids, especially before bed. Some men don't realize how much fluid they're drinking. The more fluid you drink, the more often you're going to have to urinate. The types of fluids also matter," Dr. Cheney says. "If a man is drinking a lot of caffeine, a lot of alcohol, especially before bed, that can cause nighttime issues to be worse. Some simple lifestyle tweaks can help men significantly and improve their symptoms."

"The next step in treatment of BPH is to try medications, and there are several different drug classes that we have to treat BPH. But essentially, they work on maximizing the channel through the prostate. They relax the muscle in the prostate to help open that channel or can shrink the prostate. Typically, those medications are not as effective as surgery, but they're also less invasive and less aggressive," he says.

Many types of surgeries and procedures may help with an enlarged prostate.

"If medications are not working well, we may suggest surgical management of an enlarged prostate. Less invasive surgical options include Rezum, UroLift and iTind. More definitive options would be transurethral resection of the prostate or holmium laser enucleation of the prostate," says Dr. Cheney. 

Any prostate procedure may result in side effects. Working with your healthcare team to determine the best option is essential.

Seek medical help

"It's sad to know that men are suffering out there and don't want to complain. They don't want to bring it up. It's embarrassing to admit that there's a problem there. But there are many wonderful, effective solutions to treat prostate enlargement," says Dr. Cheney.

Learn more about benign prostatic hyperplasia.

Related posts:

• Mayo Clinic Minute: Using steam to treat an enlarged prostate
• Consumer Health: Can diet ease enlarged prostate symptoms?
• Mayo Clinic Q and A: Prostate biopsies and elevated PSA

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An enlarged prostate gland can cause uncomfortable urinary symptoms, including slowing or blocking the flow of urine from the bladder. It also can cause bladder, urinary tract and kidney problems.

Benign prostatic hyperplasia affects approximately half of men over 50 and almost 90 percent of men over 80, according to American Urological Association.

There are various treatments to address benign prostatic hyperplasia, including medications, minimally invasive therapies that use lasers, steam, radio waves and microwave energy, and traditional surgery to remove the overgrown portion of the prostate.

“BPH is not a one size fits all treatment approach,” says Dr. Chandler Dora, a Mayo Clinic urologist. “The right treatment for each patient may depend on many variables, including your symptoms, your urine flow rate, the size of your prostate and your lifestyle. It’s important to review all of those pieces together to make a recommendation for what the best procedure is for each patient.”

Watch: Dr. Dora discusses enlarged prostate and treatment options.

Journalists: Broadcast-quality sound bites from Dr. Dora are in the downloads at the end of the post. Please ‘Courtesy: Mayo Clinic News Network.’

Mayo Clinic is one of the only centers in the Southeast to offer holmium laser enucleation of the prostate or HoLEP surgery. While patients often initially lean toward minimally invasive procedures, many men are surprised to learn that holmium laser enucleation of the prostate surgery provides the most complete removal of prostate tissue of any of the available procedures.

Holmium laser enucleation of the prostate surgery involves inserting an instrument into the urethra and separating the overgrowth from the shell of the prostate with a laser. Then that excess tissue is removed from the bladder. Patients remain in the hospital overnight and require a catheter for 24 hours.

“All treatments for enlarged prostate require catheter placement,” says Dr. Dora. “The amount of time a patient wears a catheter varies from procedure to procedure, so this may be an important factor to consider when deciding which treatment option to pursue.”

Link between benign prostatic hyperplasia and cancer

For some men, elevated levels of prostate-specific antigen or PSA, a protein produced by tissue in the prostate, is often the first indication of an enlarged prostate. When the prostate grows, prostate-specific antigen levels increase. When the entire prostate is removed, these protein levels fall close to zero.

“If a man comes in with an elevated PSA level, it does not necessarily mean that they have prostate cancer. And in fact, PSA is probably a better predictor of prostate size than it is the presence of prostate cancer,” Dr. Dora says.

Nonetheless, it’s important that a man with an elevated prostate-specific antigen be evaluated by a urologist who then can decide whether a biopsy is appropriate, adds Dr. Dora. Increased levels of prostate-specific antigen can occur for men who have undergone partial prostate removal for benign prostatic hyperplasia. Remaining prostate tissue might continue to grow, leading to increased prostate-specific antigen levels, or it could be a sign of infection.

“We take several factors into consideration when deciding on a biopsy: the presence of enlarged prostate symptoms, the size of the prostate estimated on digital rectal exam, and also, very importantly, what we call the PSA kinetics – what was the PSA last year? What was the PSA five years ago?” explains Dr. Dora.

The American Urological Association recommends routine prostate cancer screening for all men 55 to 69.

Men who are at an increased risk of having an aggressive prostate cancer due to a strong family history or African-American men who tend to have more aggressive prostate cancer are encouraged to have a baseline prostate-specific antigen screening prior to age 55.

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Nutrition and pain
Is your diet helping or hurting your pain? Research suggests that there's a link between diet and inflammation, which is your body's response to injury or infection. Inflammation causes heat, redness, swelling and pain in the affected part of the body. While this normal immune system response is important for healing, chronic inflammation is linked to several diseases and conditions, such as rheumatoid arthritis and heart disease. Find out which foods protect against inflammation, and which might be making your pain and inflammation worse.

EXPERT ANSWERS
Can diet help symptoms of an enlarged prostate?
The risk of an enlarged prostate, also called benign prostatic hyperplasia, increases with age. By 60, half of men will have symptoms of benign prostatic hyperplasia, including increased urinary frequency and urgency. Making healthy changes to your diet and exercise habits may help. Learn more from Jennifer Nelson, a Mayo Clinic specialty editor for food and nutrition.

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Aortic valve calcification is a condition in which calcium deposits form on the aortic valve in the heart. These deposits can cause narrowing at the opening of the aortic valve, which can become severe enough to reduce blood flow through the aortic valve — a condition called aortic valve stenosis. Aortic valve calcification may be an early sign that you have heart disease — even if you don't have any other heart disease symptoms. Learn more from Dr. Francisco Lopez-Jimenez, a Mayo Clinic cardiologist.

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Need practical advice on diet and exercise? Want creative solutions for stress and other lifestyle issues? Discover more healthy lifestyle topics at mayoclinic.org.

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Myth or Matter-of-Fact: The number of a particular procedure done each year by a provider can be one indicator of the quality.

Miss the show?  Here's the podcast: MayoClinicRadio 08-22-15 PODCAST

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeartRadio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

To find and listen to archived shows, click here.

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