Enlarged Prostate: A Complex Problem
There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect -- and how to decide.
Time to Do Something About Your Enlarged Prostate? continued...
It's not always obvious what's going on, Slawin adds. "When men start having urinary problems, it's hard to know the reason. They should see a doctor when anything changes, because there can be bladder cancer, stones, prostate cancer. BPH is often a diagnosis of exclusion … after we make sure nothing more serious is going on."
Urologists use the BPH Impact Index, a symptom questionnaire developed by the American Urological Association to determine if a man's symptoms from BPH require treatment. "It helps us understand how severe the problem is," says Slawin. Higher scores indicate more severe symptoms.
Prostate growth -- and the trouble it causes -- varies greatly from person to person, says O. Lenaine Westney, MD, division director of urology at The University of Texas Medical School at Houston. "Some people have more growth than others. Some people with very large prostates don't have trouble with voiding. It's a very individual thing."
Watchful Waiting With an Enlarged Prostate
When the symptoms of an enlarged prostate gland are mild, with low scores on the BPH Impact Index (less than 8), it may be best to wait before starting any treatment -- what's known as "watchful waiting."
With regular checkups once a year or more often, doctors can watch for early problems and signs that the condition is posing a health risk or a major inconvenience. That's where the BPH Index is especially helpful, Westney tells WebMD. "It lets us know how high the symptom score is … when to start treatment."
The "driving force in treatment," she explains, is whether the symptoms are affecting your quality of life -- and whether a blockage is causing serious complications, such as inability to urinate, blood in the urine, bladder stones, kidney failure, or other bladder problems.
A few questions to ask yourself:
- How severe are your symptoms?
- Do symptoms prevent you from doing things you enjoy?
- Do they seriously affect your quality of life?
- Are they getting worse?
- Are you ready to accept some small risks to get rid of your symptoms?
- Do you know the risks associated with each treatment?
- Is it time to do something?
Deciding on Treatment for an Enlarged Prostate
A range of treatments can relieve enlarged prostate symptoms -- medications, minimally-invasive office procedures, and surgery. The best one for you depends on your symptoms, how severe they are, and whether you have other medical conditions.
The size of your prostate gland, your age, and your overall health will also factor into treatment decisions. What's best for a man in his 50s might not be optimal for an 80-year-old. An older man may want immediate symptom relief through drugs or surgery, whereas a younger man may lean toward a minimally invasive treatment. According to the American Urological Association, surgery often does the best job of relieving symptoms, but it also has more risks than other treatments.