Prostate Enlargement: Symptoms and When to Seek Help

Suspected benign prostatic hyperplasia (BPH)?

Regarding the male external genitalia, there appears to be a noticeable difference in size above the penis, approximately where the prostate gland is located (slightly above the pubic hair area).
One side seems larger, and I am wondering if this could be due to benign prostatic hyperplasia.
I am currently 28 years old and have been actively losing weight over the past year, reducing my weight from about 85 kg to approximately 72 kg.
I noticed this condition when I reached around 75 kg.
I had surgery for a hernia at birth, but the surgery was on the right side of the body, while the visibly larger side is on the left.
I do not have any particular issues with urination.
I would like to know if this phenomenon (the asymmetry above the penis) requires examination and which specialty I should consult.
Thank you for your time.

Xiansheng, 20~29 year old female. Ask Date: 2016/02/24

Dr. Liu Jiaju reply Urology

It is recommended that you consult a urologist to rule out whether it is a hernia or other issues.
Benign prostatic hyperplasia requires a digital rectal examination for diagnosis.
Your age should not predispose you to this problem.

Reply Date: 2016/02/24

More Info

Understanding prostate enlargement, or benign prostatic hyperplasia (BPH), is crucial for men, especially as they age. BPH is a common condition that affects the prostate gland, which is located just below the bladder and surrounds the urethra. As men age, the prostate can enlarge, leading to various urinary symptoms.

Symptoms of Prostate Enlargement
The symptoms of BPH can vary but often include:
1. Frequent Urination: An increased need to urinate, especially at night (nocturia).

2. Urgency: A sudden, strong urge to urinate.

3. Weak Urine Stream: Difficulty starting urination or a weak urine stream.

4. Incomplete Emptying: Feeling that the bladder is not completely empty after urination.

5. Straining: Needing to push or strain to urinate.

When to Seek Help
If you experience any of the above symptoms, it is advisable to consult a healthcare provider. Early intervention can help manage symptoms and prevent complications. Additionally, if you notice any changes in the size or shape of your external genitalia, such as asymmetry or swelling, it is important to seek medical advice.

Your Specific Concerns
In your case, you mentioned noticing a difference in size on one side of the area above the penis, which you believe may be related to the prostate. While BPH typically does not cause visible asymmetry in the external genitalia, there are other conditions that could lead to such changes, including:
- Hernias: Given your history of surgery for a hernia, it is possible that there could be residual effects or complications from that surgery.

- Testicular Issues: Conditions affecting the testicles, such as varicoceles or epididymitis, can also lead to asymmetry.

- Lymphatic or Vascular Changes: Changes in blood flow or lymphatic drainage can cause swelling or asymmetry.

Recommended Action
Given your age and the absence of urinary symptoms, it may not be an immediate cause for concern. However, it is prudent to have a thorough evaluation to rule out any underlying issues. I recommend the following steps:
1. Consult a Urologist: A urologist specializes in male reproductive health and urinary tract issues. They can perform a physical examination and may recommend imaging studies (like an ultrasound) to assess the prostate and surrounding structures.

2. Discuss Your History: Be sure to inform the urologist about your previous hernia surgery and any other medical history that may be relevant.

3. Monitor Symptoms: Keep track of any changes in urinary habits or any new symptoms that may arise.

Conclusion
While the visible asymmetry you described may not directly indicate prostate enlargement, it is essential to have it evaluated by a healthcare professional. Early diagnosis and treatment can significantly improve quality of life and prevent potential complications. Remember, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can also contribute to overall urological health.

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