When the urges of the night set in, when the jet becomes capricious or weak, many men over 50 immediately think of cancer. In the majority of cases, it is rather an enlargement of the prostate, what doctors call benign prostatic hypertrophy or prostate adenoma, a common but annoying condition.
According to Health Insurance, the prostate normally weighs 15 to 20 g then increases in volume from the age of 40, and after the age of 70 approximately 37% of men present with an adenoma with urinary problems. After age 80, more than 75% of men have symptoms related to this hypertrophy. Health authorities point out that this disease is benign and does not increase the risk of cancer, even if the two can coexist. Understanding what is happening already helps you find a little peace of mind.
Symptoms of an enlarging prostate: signs to look out for
The prostate is a small gland located below the bladder and surrounding the urethra. When it grows, it squeezes this duct and disrupts the flow of urine. Men then describe difficulty in starting urination, a weak or interrupted flow, the impression that the bladder is not completely emptying, and frequent urges, especially at night. Getting up at night is often compatible with normal functioning, especially if more than four hours separate two visits to the toilet.
The severity of urinary symptoms does not always follow the size of the prostate. The MSD Manual mentions an IPSS symptom score ranging from 1 to 35: from 1 to 7 the disorders are said to be mild, from 8 to 19 moderate, above 20 severe. Another concrete indicator comes from alert situations: total inability to urinate, intense pain in the lower abdomen, fever or blood in the urine requires an emergency consultation.
Causes, risk factors and investigations for benign hypertrophy
The exact causes of benign prostatic hypertrophy remain imperfectly explained: age, hormonal changes linked to aging and family history. Health Insurance confirms that this hypertrophy becomes common after the age of 50. Some work suggests a role for imbalances between testosterone and estrogen, without a specific lifestyle being singled out as the sole culprit.
The diagnosis begins with a detailed interview and then a rectal exam, which allows the doctor to assess the size and consistency of the prostate. A blood test for PSA, the prostate specific antigen, often completes this assessment. In practice, a PSA greater than 4 ng/mL leads to discussion of additional examinations, depending on age and clinical context, to rule out cancer. An ultrasound can measure prostate volume and urine residual in the bladder.
Treatments and prevention when the prostate enlarges
There are several treatment options. If the symptoms remain modest, simple monitoring with adaptation of lifestyle habits may be sufficient. When discomfort increases, doctors often prescribe alpha-blockers to relax the muscles around the urethra, or 5-alpha-reductase inhibitors which, over months, reduce the size of the prostate. In the event of failure or complications, laser techniques or surgery to remove part of the gland are offered.
Total prevention does not exist, but the benefits of a diet rich in fruits, vegetables and whole grains, regular physical activity, stopping smoking and maintaining a healthy weight are proven. These measures support the bladder, limit infections and can reduce the intensity of symptoms. Finally, institutional sites recommend consulting as soon as persistent urinary problems appear, rather than waiting until the discomfort becomes disabling.