Does the Size of the Prostate Matter?

 ABSTRACT

The question of whether prostate size matters comes up frequently, especially among men of middle age and older. Prostate size alone does not determine the severity of the condition; however, in some cases, it is an important factor in assessing symptoms and deciding on treatment. For this reason, the evaluation should be based not only on size but also on the patient’s clinical condition.

When you see a doctor with symptoms such as difficulty urinating, frequent nighttime urination, or a weak urine stream, you’re often told:
“Your prostate has enlarged.”

The question that usually follows right after that is:
“So, does this size matter?”

In this article,as Prof. Dr. Volkan İzol, I will clearly explain just how important prostate size really is, under what circumstances it poses a risk, and how I approach these patients in my clinic.

🟦 What Is the Prostate?

The prostate is a gland in men that is located below the bladder and surrounds the urethra.

Position:

• To produce some of the semen

Normally:

• At a young age, it is approximately20–25 cc

📌 It tends to increase with age

🟦 Why Does the Prostate Enlarge?

🔹 Benign prostatic hyperplasia (BPH)

👉 The most common cause

🔹Hormonal changes

• The Effects of Testosterone and DHT

🔹 Aging

📌 The most common cause in my clinical practice:
👉 Age-related BPH

🟦 Does the Size of the Prostate Matter?

The answer to this question is different than you might think:

👉Prostate size alone isn't always a factor

Because:

• An enlarged prostate → does not always cause symptoms
• A small prostate → can cause serious symptoms

📌 Clinical fact:
👉 “It’s not the size that matters, but the effect”

🟦 In What Situations Is Prostate Size Important?

🔹 Very large prostate (>80–100 cc)

• It may make it difficult to urinate

🔹 If it’s blocking the urethra

🔹 If there is urinary retention

👉 In these situations, size becomes important

🟦 What Are the Symptoms?

• Weak urine stream
• Intermittent urination
• Frequent nighttime urination
• The feeling of not being able to fully empty oneself

📌 Patients usually say something like this:
“I can’t urinate like I used to.”

🟦 How Is the Diagnosis Made?

🔹 Clinical evaluation

• Complaints

🔹 Ultrasound

👉 The prostate volume is measured

🔹 PSA test

🔹Uroflow

📌 In my clinical practice, I don’t just look at cc.

🟦 Which Patients Should Be Treated?

• Those with complaints
• People who cannot urinate
• People with impaired kidney function

👉 The most important criterion:
The patient's quality of life

🟦 Treatment Options

🔹 Medical treatment

• Alpha blockers
• 5-alpha reductase inhibitors

🔹 Surgical treatment

• TUR-P
• Laser surgery

📌 Today:
👉Minimally invasive and robotic surgeryare at the forefront

👉 Laser techniques are particularly effective for enlarged prostates

🟪 My Approach in Clinical Practice

In my clinical practice as Prof. Dr. Volkan İzol, I do not focus solely on size when treating patients with prostate conditions.

What matters to me is:

• The patient's complaint
• Urinary flow
• Bladder function

In my clinical practice, I specifically see:
👉 Patients with small prostates who have severe symptoms
👉 I also see patients with large prostates who have no symptoms at all

That’s why:
👉 I don’t make treatment decisions based solely on “cc”

🟫 COMPARISON TABLE

🟫 IMPORTANT MESSAGES

• Prostate size alone is not a determining factor
• Complaints are more important
• Even a small prostate can cause problems
• An enlarged prostate isn't always dangerous
• Treatment is tailored to the individual

🟥 RESULT

Although prostate size is an important factor, it does not, on its own, determine the severity of the disease.

As Prof. Dr. Volkan İzol, my recommendation is that the evaluation of prostate diseases should focus not only on size but also on the patient’s symptoms and quality of life.

For a detailed evaluation and personalized treatment plan, please contact
Prof. Dr. Volkan İzol.

❓ FREQUENTLY ASKED QUESTIONS (FAQ)

How many cc should the prostate be?

In young people, 20–25 cc is considered normal.

Is prostate size important?

It is not evaluated on its own, but in conjunction with the complaints.

Is an enlarged prostate dangerous?

Not always; it depends on the complaint.

Can a small prostate cause problems?

Yes, it can sometimes cause serious symptoms.

When is surgery necessary?

If medication is ineffective or there is a severe blockage.