Taikang Xianlin Drum Tower Hospital｜What Does the Prostate Do? How to Manage Prostate Hyperplasia

Aug 8

3 min read

Many men in their forties and fifties may notice these changes:

They used to sleep through the whole night, yet now they frequently get up to use the restroom overnight; they once had a strong, far-reaching urine stream, but now they stand waiting for ages to start urinating; after peeing, they used to feel fully empty, while now they constantly have the sensation of incomplete voiding and need to rush to the toilet again shortly after.

Many people dismiss these symptoms as kidney deficiency or an inevitable side effect of aging. In fact, such discomfort is most likely linked to prostate issues.

01 Where Exactly Is the Prostate Located?

A healthy prostate is about the size and shape of a chestnut. It sits directly beneath the bladder and wraps around the start of the urethra like a ring.

Frequent nighttime urination, weak urine flow, and a feeling of incomplete emptying are common issues among middle-aged and older men, often linked to benign prostatic hyperplasia (BPH). This age-related condition affects quality of life but is manageable with lifestyle adjustments, medication, or minimally invasive surgery. If you experience persistent urinary discomfort, avoid self-diagnosis. Seek professional urological examination for timely and appropriate care.

The bladder serves as a urine storage organ, and the urethra carries urine out of the body. The prostate acts as a "gatekeeper" at the bladder outlet. When it stays its normal size, urine flows smoothly. However, if it swells — a condition known as benign prostatic hyperplasia (BPH) — it compresses the urethra and makes urination difficult.

02 What Are the Functions of the Prostate?

Produce a key component of semen

Semen is not merely sperm; the vast majority consists of secretions from various glands that nourish sperm and provide a medium for their movement. Prostatic fluid secreted by the prostate forms a vital part of semen.

Act as a control valve for urination

Surrounding the urethra, the prostate’s smooth muscles and sphincters work together to regulate urine discharge.

The prostate plays dual roles in urination and reproduction. Once it malfunctions, quality of life drops drastically.

03 Why Is the Prostate Prone to Hyperplasia?

Prostate hyperplasia is not strictly a disease — it is a natural sign of aging.

Physiologically, prostate growth and function are primarily regulated by androgens (testosterone). In younger years, high androgen levels keep the prostate at a standard size. As people age, hormonal balance shifts, causing the prostate to slowly and gradually enlarge.

Nearly all men will develop some degree of prostate hyperplasia if they live long enough.

Typical Symptoms of BPH

Frequent urination: Over 8 trips to the toilet during the day, more than 2 nighttime awakenings, severely disrupting sleep
Urgency: Sudden, uncontrollable urges to urinate requiring immediate access to a restroom
Hesitancy: Long waits before the urine stream starts
Weak, narrow urine stream: The once thick, far-reaching stream becomes thin and feeble
Post-void dribbling / incomplete emptying: Persistent feeling that the bladder is not fully emptied, triggering repeated urination urges soon after
Intermittent stream: The urine flow cuts off mid-stream before resuming again

While one or two mild symptoms may not feel disruptive, their combined impact greatly impairs daily life. Some seniors suffer falls and fractures from repeated nighttime bathroom trips. Others avoid social outings entirely for fear of not finding accessible restrooms, leading to social isolation.

Do these symptoms always mean prostate hyperplasia?

Not necessarily. Many conditions mimic BPH symptoms, including urethral stricture, bladder neck contracture, neurogenic bladder, bladder cancer, and more. If you experience such discomfort, do not self-diagnose or endure the pain silently — visit a hospital for professional examination and diagnosis.

04 Treatment Options for Prostate Hyperplasia

If diagnosed with BPH, there is no need for alarm. A full spectrum of treatments is available, and physicians will select the most suitable approach based on symptom severity, prostate size, and overall physical condition, ranging from conservative management to surgical intervention. Treatments fall into three main categories: watchful waiting, medication, and surgery.

Watchful Waiting

For patients with mild symptoms that do not interfere with sleep or daily routines, medication or surgery can be deferred. Focus on lifestyle adjustments: limit tea and coffee intake during the day, avoid large volumes of liquid before bedtime, maintain regular urination habits, and attend periodic follow-up checkups.

Medication Therapy

Medication is the first-line treatment for patients with obvious, life-disrupting symptoms. Common prescriptions include tamsulosin and finasteride.

Surgical Treatment

Surgery is recommended for patients who fail to respond to medication or wish to avoid long-term drug intake. Minimally invasive procedures are now the standard for prostate surgery, including transurethral resection, enucleation, urethral stenting, hydrostatic dilation, thermal steam ablation, AI-HIFU ablation, and other techniques.