Prostate Enlargement in Young Men: Causes and Solutions

Q: Prostate Enlargement in Young Men: Causes and Solutions

Hello： What could be the reasons for this issue at my age? --> Is it normal that the doctor has not prescribed any medication to suppress or improve this phenomenon since the cause is unknown? --> Since urination is normal, what can I do on my own to improve this condition or del

Young individuals can experience issues with prostate enlargement?

Hello Doctor, I am about to turn 37 this year.
For the past few years, I have been experiencing frequent urination, feeling the urge to go to the bathroom often, but it is not uncontrollable.
I initially thought it was just because I was drinking more water.
However, over the last two years, I have started to notice a sensation of incomplete emptying, where a few drops of urine still leak out after I finish urinating.

I visited a urology department at a large hospital for the first time and asked the doctor if I might have benign prostatic hyperplasia (BPH).
The doctor said that at my age, it is unlikely to have BPH and suggested that I might have overactive bladder syndrome.
He prescribed medication for overactive bladder, but it did not improve my symptoms.
During a follow-up visit, the doctor attributed my condition to psychological factors, reiterating that it is unlikely for someone my age to have enlargement issues, and advised me to gently push on the perineum after urination to help empty my bladder completely, stating that I did not need to return for further visits.

Although this method has somewhat reduced the leakage of residual urine, it has not completely resolved the issue.
This year, during a company health check, I had a prostate ultrasound, and the report indicated BPH (40mg) and a 1cm prostatic cyst.
I returned to the large hospital for a more thorough examination and consulted other doctors.
The doctors were surprised by the health check report and conducted comprehensive tests, including blood tests, urinalysis, post-void residual urine measurement, and both abdominal and transrectal ultrasounds.
The results confirmed that I indeed have BPH, but fortunately, all cancer markers were normal, and my post-void residual urine was less than 20cc.
The prostatic cyst was deemed benign.
Currently, aside from the sensation of incomplete emptying and residual urine, my sexual function and other conditions are normal.
In this situation, the doctor recommended that I continue to monitor my condition every six months and only start medication if there is any deterioration; surgery would only be considered if medication does not control the symptoms effectively.
The doctor mentioned that this type of BPH is rare in my age group and suggested that it might be more likely to be hereditary (though, to my knowledge, my father does not have this issue).

I am very curious about the underlying causes of this condition and how I can improve it.
My job requires prolonged sitting, often for two to three hours at a time, with daily work hours around 10-12 hours.
However, my sleep schedule is relatively normal, averaging from 1:00 AM to 8:30 AM.
My diet is also light, and my sexual activity is normal (1-2 times per week).
I am currently taking pumpkin seed and lycopene supplements.

Having BPH at a young age is concerning and has caused me some psychological stress.
I would like to ask the doctor what might be the underlying reasons for this issue at my age.
Is it normal that the doctor has not prescribed medication to alleviate this condition? What can I do to improve this situation or delay its worsening? Thank you very much for taking the time to review my situation and provide your advice.

Jason Chen, 30~39 year old female. Ask Date: 2021/05/30

Dr. Li Minghui reply Urology

Hello: What could be the reasons for this issue at my age? --> Is it normal that the doctor has not prescribed any medication to suppress or improve this phenomenon since the cause is unknown? --> Since urination is normal, what can I do on my own to improve this condition or delay its deterioration? --> Diet and moderate exercise, regular follow-ups.
Wishing you good health.

Reply Date: 2021/05/30

More Info

Prostate enlargement, or benign prostatic hyperplasia (BPH), is typically associated with older age, but it can occur in younger men as well. Your case, at nearly 37 years old, raises important questions about the underlying causes and potential solutions for your symptoms, including frequent urination and the sensation of incomplete bladder emptying.

Causes of Prostate Enlargement in Younger Men
1. Hormonal Changes: One of the primary factors contributing to prostate enlargement is hormonal changes, particularly the levels of testosterone and dihydrotestosterone (DHT). Even in younger men, fluctuations in these hormones can lead to prostate growth.

2. Genetic Factors: While you mentioned that your father does not have a history of prostate issues, genetics can still play a role. Family history is a significant risk factor for many conditions, including BPH, and it’s possible that other relatives may have experienced similar issues.

3. Lifestyle Factors: Your work environment, which involves prolonged sitting, can contribute to urinary issues. Sedentary behavior is linked to various health problems, including urinary tract issues. Additionally, your sleep patterns and dietary habits, while seemingly normal, can still impact your overall health and prostate function.

4. Psychological Factors: Stress and anxiety can exacerbate urinary symptoms. The psychological impact of your condition may also contribute to the perception of urgency or incomplete voiding.

5. Underlying Medical Conditions: Conditions such as diabetes or obesity can increase the risk of BPH. If you have any underlying health issues, they could be contributing to your symptoms.

Solutions and Management Strategies
1. Regular Monitoring: Since your doctor has recommended monitoring your condition every six months, it’s essential to adhere to this schedule. Regular check-ups can help track any changes in your prostate size and urinary symptoms.

2. Lifestyle Modifications:
- Exercise: Incorporating regular physical activity can improve overall health and may help alleviate some urinary symptoms. Aim for at least 150 minutes of moderate aerobic activity each week.

- Diet: Continue with a balanced diet rich in fruits, vegetables, and whole grains. Foods high in antioxidants, such as tomatoes (which contain lycopene), may be beneficial for prostate health.

- Hydration: While it’s important to stay hydrated, try to manage fluid intake, especially in the evening, to reduce nighttime urination.

3. Pelvic Floor Exercises: Kegel exercises can strengthen the pelvic floor muscles, which may help improve urinary control and reduce the sensation of incomplete voiding.

4. Medication: If your symptoms worsen, your doctor may consider prescribing medications such as alpha-blockers or 5-alpha-reductase inhibitors, which can help relax the muscles around the prostate or reduce its size.

5. Stress Management: Since psychological factors can influence urinary symptoms, consider stress-reduction techniques such as mindfulness, meditation, or counseling.

6. Avoid Irritants: Limit caffeine and alcohol intake, as these can irritate the bladder and exacerbate urinary symptoms.

Conclusion
While it is uncommon for men your age to experience significant prostate enlargement, it is not impossible. The combination of hormonal, genetic, and lifestyle factors may be contributing to your symptoms. It is crucial to maintain open communication with your healthcare provider and follow their recommendations for monitoring and potential treatment. By adopting a proactive approach to your health, including lifestyle modifications and regular check-ups, you can help manage your symptoms and potentially slow the progression of prostate enlargement. If you have further concerns or if your symptoms change, do not hesitate to seek additional medical advice.

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