Categories: Urology

Enlarged prostate: Symptoms, Diagnosis & Treatment

What is Benign Prostate Hyperplasia (BPH)?

Enlarged prostate, or what doctors refer to it as Benign Prostate Hyperplasia (BPH), is a condition associated with ageing males. The Prostate gland is a part of the male reproductive system that is about the size of a walnut and surrounds urethra below the urinary bladder. As men get old, the prostate may enlarge to an abnormal size, pressing against the normal flow of urine and urethra. Although the cause behind BPH is not identified, the changes in male sex hormones with ageing are believed to be a factor.

What are its symptoms?

The common symptoms experienced by patients are:

  • Difficulty in urination
  • Frequent and urgent need to urinate
  • Inability to empty the bladder completely
  • Painful urination
  • Weak urine flow

Although BPH is not known to cause prostate cancer in the future there are still some complications of BPH which are rate but very serious like Urinary Tract Infections, Hematuria (Blood in urine) and complete inability to urinate.

How it is diagnosed?

The primary reasons to suspect BHP are the symptoms explained by the patient which is usually confirmed by a physical examination, urinary flow test or ultrasound. A biopsy may also be done if the physician suspects it to be prostate cancer.

How it is treated?

A wide variety of treatment options are available like medication and surgery. The choice of treatment depends upon the size of the prostate, age and overall health of the patient and the severity of the symptom he is experiencing. If the surgical intervention is required for the treatment, there are two major procedures – TURP and HoLEP. Various tests and assessments need to be performed before the surgery to determine if the patient is ready to undergo surgery. In TURP special equipment called a resectoscope is inserted through the urethra up to the location where the prostate is present. This resectoscope also contains a camera that enables the surgeon to look at the internal structures in real-time. Once the resectoscope is in place, the surgeon starts to cut the prostate gland and removes the pieces through the urethra. Since the whole process is done through a urethral opening, there is no need for an incision.

HoLEP is similar to TURP in the sense that it also involves cutting and removing the parts of an enlarged prostate, but the technology and equipment used in HoLEP are much advanced and sophisticated. In this procedure, a special kind of high energy LASER, called a Holmium LASER, is used to cut the prostate. Compared to TURP, HoLEP offers lots of benefits for patients as well as physicians like minimum blood loss, less postoperative pain, better control and precision, quick recovery and discharge.

What after the surgery?

After the surgery, a catheter is placed in the urethra for a few days. This catheter supports the urethra during the healing process and helps to keep it clean and infection-free. The patient needs to stay in the hospital for 3-4 days and after discharge, most of the patients go back to their normal routine in 2 weeks although they are advised to refrain from heavy exercise for 1 to 2 months.

Dr. Varun Sharma, Consultant Kidney Transplant – Adult & Urology, MMI Narayana Multispeciality Hospital, Raipur

Narayana Health

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