Why an Enlarged Prostate Might Lead to Urinary Troubles

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Among other problems, benign prostatic hyperplasia (BPH) can rob you of sleep and make you miserable and anxious, with all the extra toilet trips and time spent desperately searching for bathrooms in public places. But if BPH, also known as an enlarged prostate, is a prostate problem, why does it cause urinary symptoms?

The prostate is a gland located beneath the bladder, behind the pubic bone and base of the penis and in front of the rectum. Shaped like a crab apple and weighing only about an ounce in young men, the prostate surrounds the urethra (the tube that carries urine away from the bladder and transports semen during ejaculation). The prostate is not a component of the urinary system, but with its proximity to the urethra it can affect urinary function.

While a healthy prostate does not interfere with the flow of urine from the bladder, an enlarged gland can cause urinary symptoms. In BPH, prostate tissue closest to the urethra begins to grow. The enlarging tissue puts pressure on the urethra and ultimately restricts urine flow. The bladder must then work harder to push urine through the constricted tube. Over time, the overworked bladder develops a thickened wall, which reduces the organ’s capacity to store urine.

In about half of men with BPH, these developments lead to urinary symptoms such as a delayed or weak urine stream, increased urinary frequency or urgency, the need to get up during the night to urinate, and painful urination.