Baltimore Colts football legend Johnny Unitas will launch a national program tomorrow to inform men about benign prostate enlargement, a noncancerous condition that eventually affects most men over the age of 60.

The 61-year-old former quarterback, who is being treated for the condition, is spokesman for "The Partnership for Prostate Health," a project organized by the Prostate Health Council, the National Council on Aging and various prostate health centers. It is paid for by Merck & Co. Inc., which manufactures Proscar, a drug that treats the condition.

Mr. Unitas discovered his prostate was enlarged after talking to his physician about his increasing tendency to urinate frequently at night. He is following a course of "watchful waiting," seeing his doctor every three months to discuss any change in symptoms.

"I had no idea that my urinary problems were caused by prostate enlargement or that I could do something about them," he has said about his condition. "I've learned first-hand that there's no reason to let fear or embarrassment keep you from getting medical attention that can keep you healthy."

The most common symptoms of this disease are problems with urinating such as sudden, uncontrollable urges to urinate, getting up to urinate frequently at night, feeling as if the bladder has not emptied, difficulty in beginning to urinate, and a slow or weak urinary stream.

Complications can include urinary tract infections, sudden inability to urinate and gradual bladder and kidney damage.

Benign prostate enlargement, also known as benign prostate hyperplasia, is caused by aging and hormones. There is nothing men can do to prevent it. The prostate is a walnut-sized gland just below the bladder and makes the fluid that carries sperm. The gland wraps around the urethra, the tube that conducts urine from the bladder through the penis. Through aging, the prostate can become larger than normal, squeezing a man's urinary tube until it eventually blocks the flow of urine.

The chances of developing prostate trouble increase as men age; the disease rarely occurs in men younger than 50. More than half of men over the age of 60 are affected by benign prostate enlargement. An estimated seven million men in the United States show urinary symptoms now, according to the Prostate Health Council. However, only some men with actual symptoms require treatment.

The first step in treating the problem involves educating men to realize they have the condition, physicians say.

"A lot of men are fearful of mentioning urination problems to their doctor because they are afraid it might be prostate cancer," says Dr. Michael Naslund, director of the Prostate Center of the University of Maryland Medical Center who is working as a spokesman with Mr. Unitas.

Although it usually causes no symptoms in its earliest, most treatable stages, prostate cancer may cause urinary symptoms in its later stages. Every year, roughly 35,000 men in the United States die from prostate cancer and 200,000 new cases are diagnosed.

"Older men don't want to admit vulnerability, to admit that something may be wrong with them," says Dr. Naslund. "But it's not in a man's interest to worry about his urination difficulties and not find out what's wrong."

For most men, benign prostate enlargement is not about pain, but about altering their lifestyle, says Dr. Naslund. "And it's a condition that the patient and physician have to talk about: Men can't really diagnose it themselves."

Treatments for the condition range from "watchful waiting" to surgery. Surgery offers the best chance for relieving symptoms, but also the greatest risk for complications, according to the Agency for Health Care Policy and Research of the U.S. Department of Health and Human Services. (For a copy of its booklet on benign prostate enlargement, call toll-free [800] 358-9295.)

According to patient guidelines issued recently by the federal agency, men with benign prostate enlargement can consider these treatment options:

* Watchful waiting: If symptoms are not too troublesome, men can schedule regular exams to monitor the condition. Some physicians may suggest consuming fewer liquids before going to bed and eliminating over-the-counter cold and sinus medicines with decongestants, which can worsen a prostate condition. Without treatment, the condition may get better, stay the same or get worse.

* Alpha blocker drug treatment: These drugs are taken by mouth once or twice a day to help relax muscles in the prostate. Although some men will notice urinary symptoms improve, there is no evidence that alpha blockers reduce the rate of prostate enlargement complications or the need for future surgery. Potential side effects include headaches as well as feeling dizzy, lightheaded or tired. Because this treatment is new, doctors do not know its long-term effects. Currently, terazosin (Hytrin) is the only alpha blocker approved for prostate enlargement treatment the Food and Drug Administration.

* Finasteride drug treatment: Finasteride (Proscar) is taken by mouth once a day to help shrink the prostate. Some men notice an improvement in urinary symptoms, but it may take as long as six months to realize the drug's full benefits. There is no evidence that the drug reduces the rate of prostate enlargement complications or the need for future surgery. Side effects include less interest in having sex and performance complications. Because finasteride treatment is new, doctors do not know its long-term effects. Also, the drug lowers the blood level of prostate-specific antigen, which may affect the ability of the blood test to detect prostate cancer.

* Balloon dilation: This treatment stretches the urethra where it has been squeezed by the prostate. After the patient gets

anesthesia, the doctor inserts a plastic tube through the urethra and into the bladder. The doctor inflates a balloon at the end of the catheter to stretch the urethra. This treatment makes the urine flow more easily for some patients. It can also cause bleeding or infection, and some men are unable to urinate for a while. Without any complications, a patient can go home the same day. In many patients, this treatment seems to work for only a short time. Because this procedure is fairly new in treating prostate enlargement, doctors do not know all of its long-term effects.

* Surgery: Because surgery has been used for many years as a treatment, its benefits and risks are well known. Compared with other treatments, surgery has the best chance of relieving symptoms, although it also carries the highest risk of causing major problems.

Surgery is generally recommended for men with such prostate-caused problems as inability to urinate, urine backup into the kidneys that damages those organs, frequent urine infections, major bleeding through the urethra and stones in the bladder.

Transurethral resection of the prostate is the most common surgical procedure for this condition. It is performed hundreds of thousand of times a year, more than any other single in-patient surgery in the United States. This surgery relieves symptoms by reducing pressure on the urethra. After administering anesthesia the patient, the doctor inserts an instrument into the urethra and removes part of the inside of the prostate. No skin is cut.

The patient usually stays in the hospital for two to three days, and wears a catheter to drain urine for about the same period of time. Most patients find their symptoms improve quickly after this procedure and that they do well for many

years.

Potential problems of surgery include urinary infection, bleeding that requires transfusion, and a blocked urine flow. Surgery also may cause retrograde ejaculation, a condition in which semen flows back into the bladder rather than out of the penis. Roughly 3 percent to 35 percent of surgery patients will experience impotence after treatment, although such a reaction is uncommon in men who were functioning normally before surgery.

* New treatments: Physicians also are trying new high-tech options such as laser surgery, microwave thermal therapy and focused ultrasound treatment.

Johns Hopkins Hospital at Bayview is one of five sites in the nation testing an instrument that uses high-intensity, focused ultrasound to destroy enlarged, obstructed prostate tissue. (This testing is necessary for Food and Drug Administration approval.) In this outpatient treatment, a transrectal probe destroys unwanted tissue with carefully focused ultrasound, says Dr. Robert Moore, a Hopkins urologist. (Available to men who have not had prior surgery for the condition, this new treatment and follow-up is offered free of charge. For details, call [410] 550-0403.)

The American Urological Association and the American Cancer Society recommend that men over the age of 50 receive a yearly prostate examination and blood test. African-American men and men with a family history of prostate cancer should begin yearly examinations in their 40s. Although prostate enlargement is not cancer and does not lead to it, men can have both diseases at the same time.

The Partnership for Prostate Health wants to encourage men to talk more openly about urinary problems.

"One general misconception men have is believing their symptoms are something you just live with," Dr. Naslund says. "There's also the fact that the prostate is a sexual organ and men don't want to deal with the possibility that there could be something wrong. But a man in his 60s who's having problems can bet that at least half of his friends are having some of the same problems."