Enlarged Prostate

An enlarged prostate (also known as benign prostatic hyperplasia, benign prostatic hypertrophy, or BPH) is a common condition in middle-aged or older men. The most common symptoms of an enlarged prostate include:

  • Difficulty starting a stream of urine
  • A urine stream that is not continuous (starting and stopping)
  • Urinating frequently or feeling an urgent need to urinate
  • Getting up several times during the night to urinate
  • A feeling that the bladder is not empty after urinating
  • Dribbling after urinating

Causes of Enlarged Prostate

Although there are some theories, there is no known cause for BPH. It is generally considered a normal part of the aging process in men.

Enlarged Prostate and Erectile Dysfunction

Recent studies have shown that there may be a connection between prostate enlargement and erectile dysfunction, although more research is needed.  In order to determine if your ED is being caused by an enlarged prostate, you will need to undergo some tests to rule out other causes. Those tests might include:

  • A complete physical exam, including a thorough examination of your penis, testes, prostate, rectum, and abdomen
  • A complete medical history, including information about your erections, sexual partners, and sex life
  • Blood tests to check for low testosterone levels, diabetes, thyroid problems, high cholesterol, and other potential health issues
  • Urine tests to check for diabetes, kidney disease, and low testosterone levels
  • An ultrasound to check for venous leak, clogged arteries, and tissue scarring
  • An overnight erection test to see if the cause of your ED is physical or psychological
  • A psychological exam

Once other causes of ED have been ruled out, there are also some tests that are specifically used to diagnose prostate enlargement. Those tests include:

  • A digital rectal exam: a simple test that is done by inserting a finger in your rectum to feel the size and shape of your prostate.
  • Cystoscopy: a test that involves inserting a small tube (cystoscope) into your urethra to check for blockage, which will help to estimate the severity of your BPH.
  • Urine flow studies: tests that require you to urinate into special receptacles to test how quickly your urine is flowing. A decreased flow may be a sign of an enlarged prostate.

Treatment for ED and Enlarged Prostate

To treat erectile dysfunction caused by prostate enlargement, the enlarged prostate will need to be treated. Treatments for BPH may include:

  • Medications (alpha-blockers, Cialis)
  • Transurethral resection of the prostate (TURP): a surgical procedure to remove excess tissue from the prostate. A cystoscope is inserted through your urethra, and the excess tissue is cut away and removed.
  • Laser surgery: minimally-invasive surgery that uses a laser to destroy excess prostate tissue. The laser is inserted through your urethra.
  • Transurethral microwave procedures: the use of microwaves to destroy excess tissue via an electrode that is inserted through your urethra
  • Transurethral needle ablation (TUNA): the use of radio waves to heat and destroy excess tissue. The radio waves pass through needles that are placed in your prostate gland via a cystoscope.

For more information on prostate enlargement and ED, contact Leroy Jones, MD, urology specialist of San Antonio.