The symptoms of prostate enlargement are similar to prostate cancer (Image: GETTY)
The prostate is a small internal gland found in men that sits between the penis and the bladder. It surrounds the tube that carries urine out of the body, known as the urethra, and its job is to produce thick, white fluid that gets mixed with sperm to create semen.
It’s about the size and shape of a walnut and tends to get bigger as men get older.
This natural enlargement is known as benign prostatic enlargement, also called BPE or BPH in other countries.
It’s very common, usually seen in men over the age of 50, and doesn’t usually cause any serious health issues.
Some patients with an enlarged prostate may be worried they’re at higher risk of prostate cancer. But according to NHS GP Dr Khalid Zalmay, the two are not linked.
READ MORE ‘I went to see my GP to stop smoking and found out I had prostate cancer’
But the symptoms of both can be very similar, so it can be difficult to distinguish between one and the other.
Dr Zalmay, who is a family doctor in London with more than 111,000 subscribers on YouTube, created a video for his channel explaining the signs and symptoms of prostate enlargement to look out for.
Signs and symptoms
1. Needing to be frequently
This is the most common symptom, according to Dr Zalmay. He said: “Say you’re playing video games, cooking or out shopping and every couple of hours you’re having to stop what you’re doing, and running off to the toilet, and it’s more often than usual. This is known as increased frequency.
“It means you’re passing urine more than usual. When your prostate enlarges it can press on a tube taking urine out of your bladder. This can narrow the flow and this pressure can cause the bladder to become more irritable, causing it to contract more often, not always when it’s full. And this means that you go to the toilet and pass urine more often.”
2. Needing to pee urgently
When the prostate enlarges and presses on the urethra, it can also increase the need to pee.
Dr Zalmay said: “As well as going more often, people will find they just have to rush off to the toilet, and this ability not to hold your urine as much as before is down to the mechanism we’ve just spoken about.”
Needing to pee more frequently can be a sign (Image: GETTY)
- Support fearless journalism
- Read The Daily Express online, advert free
- Get super-fast page loading
3. Waking up at night to pass urine
This is called nocturia. Dr Zalmay said: “This is one of the more problematic symptoms of prostate enlargement. I don’t mean life threatening or causes you a health issue. Problematic in the sense that people who I speak to and have this issue tend to find that a real pain in the backside – one of the things they complain about the most.
“It wakes them up in the night, they get a poor night’s sleep, they’re tired the next day, they’re more snappy and it’s just difficult to control.”
4. Hesitancy
If you go to the toilet and it’s taking a little bit longer to get things flowing, this is called hesitancy, and it’s one of the signs of prostate enlargement, said Dr Zalmay.
He explained: “You may find that the initial starting step of weeing takes longer or the flow itself is affected. Again, this is often due to the urethra being pressed and narrowed by an enlarged prostate.”
5. Poor urinary stream
People often find with an enlarged prostate that their normal trajectory, power, stream that they used to have before when peeing, feels more diminished.
Dr Zalmay said this could include “getting a little bit more dribbling, it may be stopping or starting, the flow may not be as good as it was before”.
Hesitancy can be another sign (Image: GETTY)
6. Leaking after you’ve stopped passing urine
After you’ve had a wee you may have some leakage in your underwear later on.
Dr Zalmay said: “This is a little bit of an embarrassing topic for men to talk about because they get a little bit self conscious about their hygiene, the smell of urine and what’s going on.
“Often the cause is the urine that’s left in the tube, the urethra, starts to leak out.”
7. The feeling of not completely emptying your bladder
If you get a feeling there’s still a little bit left after peeing, it could be a sign of prostate enlargement.
Dr Zalmay said: “It can sometimes affect people in a way where they’re not confident to go outside, shopping, travelling, where they don’t know if there’s going to be toilets nearby because they’re having to go to the toilet a lot more often.”
8. Not passing urine at all
Dr Zalmay said this is a more worrying symptom – a bit of a combination of symptoms.
He said: “If you notice you’re not passing any urine at all or only a very few drops of urine and you notice lower abdominal pain or bloating, your tummy feels a bit more fuller, this could be something called urinary retention.
“Some people who get this can also get pain in their lower abdomen and it’s a medical emergency. And the reason for this is basically your bladder is getting all like a balloon, and there seems to be a blockage. Often it could be the prostate pressing and completely blocking that tube taking urine out.
“So if you’ve got nowhere for the urine to go, it will continue to get bigger and bigger.”
Dr Zalmay said acute urinary retention is treated as a medical emergency. If you’re getting these symptoms, seek medical help as soon as you can.
How can you tell the difference between prostate cancer and prostate enlargement
It can be impossible to distinguish the two apart because the symptoms are so similar, said Dr Zalmay.
But there are a few extra symptoms to look out for that you’re more likely to have if you have prostate cancer:
1. Blood in your semen and if you’re over the age of 40
2. Blood in urine
3. Unintentional weight loss
4. New night sweats
5. Bony back, rib, chest pains – this can occur if cancer has spread to the bones.
If you experience these symptoms you should get checked out as soon as possible.
Dr Zalmay said: “The only way to really know is to go speak to your healthcare professional because they’ll need to do some tests.”
