Trouble Urinating: Is My Prostate Enlarged?

As men age, the development of an enlarged prostate is an issue more than likely to crop up over time. Medically, this is referred to as benign prostatic hyperplasia. Over half of men above age 60 will eventually face this, and this estimate rises to 80% by age 90.

As you get older, the prostate grows in size by around 2% per year. This expansion can gradually obstruct your urethra, by constricting around it like a donut. This leaves less space for urine to pass through as you age, increasing the chances of issues with urination.

Some frequently-seen symptoms of an enlarged prostate include:

• More frequent urges to urinate (e.g. often waking up at night needing to pee)
• More urgency when needing to pee
• Urination weakness
• Difficulty in emptying your bladder fully

Your doctor will check your prostate health based on the symptoms you face, through a physical examination of your rectum, a prostate-specific antigen (PSA) and urine test.

Occasionally, further screening such as transrectal ultrasound, abdomen ultrasound, multiparametric magnetic resonance imaging (MRI) , uroflowmetry or cystoscopy may be needed. A higher PSA level could suggest a larger prostate size and a higher risk for prostate cancer.

A few common questions your doctor may ask include:

• Over the past month, how often have you:
  • Felt like you didn’t empty your bladder fully, even after urinating?
  • Felt a repeated urge to urinate in under 2 hours?
  • Had your urine flow stop and restart a few times while urinating?
  • Had difficulty holding your urine?
  • Needed to push or strain in order to urinate?
  • Needed to wake up at night to urinate?

• If you had to spend the rest of your life with your current urinary function, how would you feel about it?

Notably, some common over-the-counter cold medications can also worsen issues with urination. This is because the receptors that they target in the nose and sinuses are also found in the bladder and prostate.

If you remain worried about issues with your prostate, or difficulties with urination – rest assured that these are normal to face as you grow older. Getting a check-up at an early stage is a good chance for you to take charge of your health as you age, and catch any urgent issues early on.

If you do have an enlarged prostate, your doctor will likely avoid encouraging you to undergo treatment, unless necessary. Active surveillance, as well as behavioral and dietary modifications are common and safe strategies used to manage the issue.

Learn more: Treatments for an Enlarged Prostate

These are some common questions you may have about your prostate health.

What does the prostate exam feel like?

During your prostate exam, you will likely be asked to lie on your side, with your knees bent slightly forward. Your doctor will use a lubricating gel to ease the insertion process, which may feel cold. They will then place a finger into your rectum in order to feel and estimate the relative size of your prostate, as well as to check for any abnormalities. Your prostate gland is usually found 1 to 2 inches deep, next to your rectum, which is as far as your doctor will need to go.

Is my prostate size normal? / What's the size of a normal prostate?

Generally, for middle-aged men, a normal-sized prostate weighs around 20 to 25 g (just below an ounce), the weight of an AA battery. A moderately enlarged prostate would range from 30 to 50 g (1 to 1.75 ounces), similar to a slice of bread. A severely enlarged prostate would weigh above 50 g (1.75 ounces), more than a medium-sized chicken egg. However, size is not everything, and the severity of your symptoms will also need to play a role in diagnosis.

Can I treat my enlarged prostate naturally?

Currently, there are many supplements for prostate health found on the market, including zinc, saw palmetto and selenium. However, the current consensus from the American Urological Association remains that most trials for these supplements so far seem speculative, and lack robust evidence for their efficacy.

Does an enlarged prostate mean cancer?

Not necessarily. While the urinary symptoms of both conditions may overlap, having an enlarged prostate does not increase your risk for prostate cancer. However, it is possible to face both an enlarged prostate and prostate cancer at the same time. A PSA test and physical examination of your prostate will help your doctor best determine if you are at a higher risk of prostate cancer.

Learn more: Don't Panic: BPH is Not a Gateway to Prostate Cancer