King Charles' prostate treatment is common among men his age

King Charles III will undergo a procedure in a hospital next week to address an enlarged prostate. The 75-year-old British monarch's diagnosis is common in men his age, and experts say typical treatments are not dangerous.

An enlarged prostate, also called benign prostatic hyperplasia or BPH, is a benign condition that often occurs in older men. At the age of 60, more than half of the men has at least mild BPH symptoms, including difficulty urinating and a sense of urgency to urinate. But often the symptoms are not severe enough to require treatment.

The condition is analogous to menopause in women, said Dr. Peter Albertsen, a urologist and prostate specialist at the University of Connecticut. Menopause usually begins around age 50, when levels of testosterone and estrogen begin to change. The same thing happens in men, said Dr. Albertsen, and at the same age.

“We think it's the changing ratio of testosterone to estrogen,” he said. “The way the man reacts is that the prostate gets bigger. It is a normal aging process.”

The prostate is shaped like a donut that surrounds the urethra, the tube that carries urine from the bladder to the penis. When the prostate grows, the tube becomes compressed, said Dr. Judd W. Moul, a urologist and prostate specialist at Duke University.

Most men notice symptoms, he added. They urinate more often, they get up at night to urinate. Their urine flow is weaker.

If symptoms become more severe, men are usually treated with this medicines to relax the prostate. Dr. Albertsen said doctors typically start by prescribing an alpha blocker, such as terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral) or silodosin (Rapaflo).

Another choice is finasteride (Proscar or Propecia), which blocks the conversion of testosterone to dihydrotestosterone, the hormone that causes the prostate to enlarge.

If the prostate continues to grow despite medical treatment – ​​which can happen when men reach Charles' age – some may need surgery.

Buckingham Palace did not describe on Wednesday what procedure Charles would undergo. But experts say the most common and appropriate treatment is transurethral resection of the prostate, or TURP. A surgeon scrapes away the inside of the prostate gland, creating more space for the urethra. The surgery has been used for 100 years, said Dr. Moul.

Men with a TURP usually go home that day or the next day and have a catheter in to drain urine for the next day or two.

More recently, new surgical treatments have been introduced, including an electric cutting loop to destroy prostate tissue, steam to vaporize prostate tissue, and a system that uses implants to hold the prostate away from the urethra.

Although techniques vary, all surgeries have the same goal: to make the prostate smaller.

“The best operation,” said Dr. Moul, “is the operation that the most experienced surgeon performs skillfully.”

None of the surgeries are grueling, added Dr. Albertsen added.

Surgery for benign prostatic hypertrophy “is not a problem,” he said.