From the FDA Drug Label
The symptoms associated with benign prostatic hyperplasia (BPH) are related to bladder outlet obstruction, which is comprised of two underlying components: static and dynamic. The static component is related to an increase in prostate size caused, in part, by a proliferation of smooth muscle cells in the prostatic stroma However, the severity of BPH symptoms and the degree of urethral obstruction do not correlate well with the size of the prostate. The dynamic component is a function of an increase in smooth muscle tone in the prostate and bladder neck leading to constriction of the bladder outlet Smooth muscle tone is mediated by the sympathetic nervous stimulation of alpha 1 adrenoceptors, which are abundant in the prostate, prostatic capsule, prostatic urethra, and bladder neck. Symptoms were quantified using a score similar to the American Urological Association Symptom Score, which evaluated both obstructive symptoms (impairment of size and force of stream, sensation of incomplete bladder emptying, delayed or interrupted urination) and irritative symptoms (nocturia, daytime frequency, need to strain or push the flow of urine) by rating on a 0 to 5 scale for six symptoms and a 0 to 4 scale for one symptom, for a total possible score of 34.
The symptoms of prostate issues in young adults include:
- Obstructive symptoms:
- Impairment of size and force of stream
- Sensation of incomplete bladder emptying
- Delayed or interrupted urination
- Irritative symptoms:
- Nocturia
- Daytime frequency
- Need to strain or push the flow of urine 1
From the Research
Prostate issues in young adults typically manifest as pain or discomfort in the pelvic region, painful urination, frequent urination, difficulty starting urination, weak urine stream, blood in urine or semen, painful ejaculation, and sometimes lower back pain. These symptoms often indicate conditions like prostatitis (inflammation of the prostate) rather than benign prostatic hyperplasia or cancer, which are more common in older men. Young men experiencing these symptoms should seek medical attention promptly, as early treatment with antibiotics like ciprofloxacin (500mg twice daily for 2-4 weeks) or trimethoprim-sulfamethoxazole (160/800mg twice daily for 2-4 weeks) can effectively resolve bacterial prostatitis 2. Non-bacterial forms may require anti-inflammatory medications, alpha-blockers like tamsulosin (0.4mg daily), or pelvic floor physical therapy. Lifestyle modifications including increased water intake, avoiding caffeine and alcohol, and warm sitz baths can provide symptomatic relief. The prostate's location surrounding the urethra explains why inflammation or infection causes urinary symptoms, while its role in seminal fluid production accounts for sexual function-related symptoms. Some key points to consider when evaluating prostate issues in young adults include:
- The importance of prompt medical attention to address symptoms and prevent complications
- The role of antibiotics in treating bacterial prostatitis
- The potential need for anti-inflammatory medications, alpha-blockers, or pelvic floor physical therapy in non-bacterial cases
- The benefits of lifestyle modifications in managing symptoms. It's worth noting that while finasteride and dutasteride are commonly used to treat benign prostatic hyperplasia, their efficacy and safety in young adults may vary, and the most recent study 2 suggests that dutasteride may be more effective in improving certain symptoms. However, the primary concern in young adults is often prostatitis rather than benign prostatic hyperplasia, and treatment should be tailored to the specific condition and symptoms presented.