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Enlarged Prostate - Causes

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Prostatitis

  • Acute (severe) infectious prostatitis: This may be caused by a bacteria or virus.

  • Chronic (long-lasting) infectious prostatitis: This may be caused by bacterial infection as well. Stress, caffeine, nicotine, or alcohol may worsen this condition.

  • Noninfectious prostatitis: This form of prostatitis is caused by inflammation in the prostate, which is not due to bacteria and therefore antibiotics may not be helpful. This is the most common type of prostatitis. It may be exacerbated by stress and/or irregular sexual activity. Stress may cause the pelvis muscles to tighten and cause pain. Increased pressure during voiding may cause urine to back up into the prostate ducts resulting in inflammation (a form of chemical prostatitis). The prostate gland helps produce the seminal fluid (the fluid that comes out during ejaculation, which carries the sperm), and infrequent ejaculation may cause the ducts to become clogged with secretions.

Prostate Enlargement

Two conditions are necessary for the development of BPH; namely, aging and the presence of testes. It is well known that human males who are castrated prior to the time of puberty never develop BPH. Benign prostatic hyperplasia (BPH) is a common but incompletely understood consequence of aging.

  • An enlarging prostate and the development of LUTS (lower urinary tract symptoms) are an unfortunate consequence of aging. The prostate gland grows with men as they age. The reason for this is not well understood.

  • The development of BPH happens under the influence of Testosterone, the male hormone. Testosterone, and its metabolite Dihydrotestosterone (DHT) act on individual prostatic cells to cause cell growth and cell prolifetation, which results in the prostate increase in size. Normally, the prostate gland is approximately the size of a walnut. As men age, and under the influence of male hormones the prostate can grow to many times its normal size. In some men, it may become as large as a grapefruit.

Bladder Outlet Obstruction

The most common cause of a bladder outlet obstruction is an enlarged prostate. Additional causes include can include prostate cancer, narrowing of the urethra or bladder outlet scarring from infection, injury or surgery or bladder stones. Bladder outlet obstruction may also occur as a side effect of certain medications, such as antihistamines and decongestants, commonly found in allergy and sinus medications.

Once bladder outlet obstruction has been confidently diagnosed it is helpful to think of this concept as being attributable to both static and dynamic factors. The static component of bladder outlet obstruction may be attributed to the physical enlargement of the prostate as it encroaches on the urethra and bladder. The dynamic portion of the obstruction is more likely related to the relative tension of muscle fibers found in the prostate and bladder. It is particularly useful when formulating a strategy for the treatment of bladder outlet obstruction to consider whether the bladder muscle is intact. A variety of conditions such as Diabetes Mellitus, may result in a bladder muscle that is unable to squeeze hard enough to push urine out the bladder, and through the urethra.