Enlarged Prostate: A Condition That Disturbs Sleep and Peace of Mind - Dr Sarath Chandra Reddy

As men age, they encounter various health challenges that can affect their quality of life. One of the most common and often neglected conditions is prostate enlargement, medically referred to as Benign Prostatic Hyperplasia (BPH).

While not cancerous, this condition can significantly impact day-to-day life, sleep patterns, and overall well-being if left untreated.

For nearly 30 years, civil engineer Maheshwar (57) never once had to wake up in the middle of the night after going to bed. But for the past two months, he has been waking up at least twice every night.

Because of frequent trips to the bathroom, he could no longer enjoy deep, restful sleep. Initially, he thought it might be because of drinking more water in summer or due to the cool bedroom environment with air conditioning.

But when urination became increasingly difficult and the urge started troubling him even during daytime, he consulted a doctor. After evaluation, he was then diagnosed with BPH, a condition seen in nearly 50% of men by the age of 60, rising to almost 90% by the age of 85.

Why does it occur? What are the symptoms?

Prostate enlargement is a non-cancerous condition. The prostate gland surrounds the urethra (the tube that carries urine from the bladder out of the body). When the gland enlarges, it exerts pressure on the urethra, narrowing the passage.

This forces the bladder to contract more strongly to push urine out. Over time, the bladder muscles become thickened, sensitive, and less effective. Even a small amount of urine in the bladder then creates the urge to urinate. Because of the narrowed passage, the bladder never empties completely, leading to frequent trips to the toilet.

The earliest and most common symptom is frequent urination at night. Later, this extends to daytime, along with difficulty starting urination, weak urine stream, dribbling, and incomplete emptying.

If ignored, it may lead to urinary tract infections, bladder stones, kidney damage, and in severe cases, acute urinary retention (sudden inability to pass urine), which is a medical emergency requiring immediate attention.

Neglecting symptoms worsens the problem

Many men ignore prostate enlargement and continue to suffer for months or years. Night-time urination leads to disturbed sleep, daytime fatigue, and difficulty concentrating. Only when the symptoms become unbearable do patients approach a urologist. In some cases, men delay treatment until they can no longer pass urine at all.

The severity of prostate enlargement varies from person to person. In some, the gland grows rapidly, causing significant problems, while in others it enlarges slowly with minimal symptoms. Treatment decisions should be based on the severity of symptoms, their impact on daily life, and progression over time.

Even if the condition is mild, yearly consultations with a urologist, along with necessary tests and prescribed medicines, help in preventing complications like blood in urine, bladder stones, or kidney failure.

Treatment options

Prostate enlargement can be managed effectively with modern medical and surgical treatments. Options include:

• Medications that relax the prostate and bladder muscles, improving urine flow. These are often the first line of treatment and work well for many patients.

• Minimally invasive procedures that require only small incisions and allow faster recovery, sometimes on the same day.

• Surgical treatment, which is recommended if the prostate is significantly enlarged or if other treatments fail. Removing the excess prostate tissue provides long-term relief and has been proven effective worldwide.

Prostate enlargement is not cancer, but it can cause significant distress and affect quality of life. While it is often compared to natural signs of ageing, like greying hair, its complications should not be ignored.

Timely consultation with a urologist, proper evaluation, and appropriate treatment can bring remarkable relief and prevent serious health problems.

As a medical oncologist, I frequently see patients who mistake prostate enlargement for cancer-related issues or delay care out of fear. The truth is, early medical attention not only rules out cancer but also ensures that a common, manageable condition does not escalate into a severe health crisis.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.