An enlarged prostate gland becomes more common with with age. An enlarged prostate gland can produce significant urinary symptoms. Enlarged prostate glands are often seen on imaging of the pelvis like CT and MRI.
What causes an enlarged prostate?
The gland enlarges with normal aging in many men. We do not know why this happens for sure but it may be related to changes in hormones as men age.
Prostate enlargement can occur from prostate cancer when it is large or found throughout the gland.
An inflamed prostate gland called prostatitis can also cause some enlargement. Sometimes an abscess or pocket of pus can be found in the gland which can contribute to enlargement.
Enlarged prostate symptoms
An enlarged prostate gland can produce urinary symptoms like: difficulty starting urination, frequent urination, urination at night, inability to empty the bladder completely, stopping and then starting of the urine flow, and weak urine flow.
Prostate gland location and function
The gland is located below the bladder by the rectum. The gland produces fluid which makes up part of the semen.
Enlarged prostate on CT
CT can detect an enlarged gland. CT is not good at identifying many abnormalities of the prostate gland. Cancers and inflammation are not well seen.
We can sometimes see large cancers on CT, particularly those that extend into adjacent tissues. We can also see spread of prostate cancer to other imaged sites in the body.
We can sometimes see inflammation and abscesses or pockets of pus.
The typical volume cutoff is 30 cc to diagnose prostate enlargement. An experienced radiologist can usually tell if the gland is enlarged from experience.
Enlarged prostate on MRI
MRI of the prostate is the best test to diagnose enlargement and many abnormalities like cancer, inflammation, and abscess. An MRI designed to image the prostate is often done for men who have a suspicion for cancer based on blood tests or exam findings.
Does an enlarged prostate gland mean there is cancer?
An enlarged gland does not mean you have cancer or any disease process in itself. Cancer or inflammation often occurs in men with enlarged prostate glands however.
Testing of enlarged prostate
Further investigation will include a detailed history, getting blood tests, digital rectal exam by your doctor and more advanced imaging tests like prostate MRI. Biopsies may be taken when there is concern for cancer.
What is BPH in medical terms?
BPH stands for benign prostatic hyperplasia and is used interchangeably with prostate gland enlargement.
Enlarged prostate treatment
Trestment includes medications, surgery and minimally invasive procedures. Urologists usually manage an enlarged prostate.
Treatment is offered when there are bothersome symptoms.
Complications of an enlarged prostate can include a thickened bladder, bladder infections, bladder stones, and damage to the kidneys.
Enlarged prostate: summary
An enlarged prostate is commonly seen as men get older. We see this commonly on imaging tests like CT and MRI. Imaging often plays an important role in biopsy planning of the prostate and identifying significant inflammation and cancers. Imaging is also important for seeing if prostate cancers have spread behind the prostate gland.
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