Enlarged prostate Treatment Delhi NCR
The prostate is a gland that produces the fluid which carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through which urine passes out of the body. An enlarged prostate means the gland has grown bigger. Prostate enlargement is common in older men. An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.
The actual cause of prostate enlargement is unknown. Factors linked to ageing and changes in the cells of the testicles may have a role in the growth of the gland, as well as testosterone levels. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.
Also, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.
Some facts about Enlarged prostate Treatment Delhi NCR
- The likelihood of developing enlarged prostate increases with age.
- BPH is so common that it has been said all Men will have an enlarged prostate if they live long enough.
- A small amount of prostate enlargement is present in many Men over age 40. More than 90% of men over age 80 have the condition.
- No risk factors have been identified, other than having normally functioning testicles.
- For most men, these nightly bathroom runs may be the first sign of an enlarged prostate. Other symptoms may include trouble starting a stream of urine, leaking, or dribbling. And, like grey hair, an enlarged prostate is a natural by-product of getting older, doctors say. Trouble is, the nightly bathroom runs become more frequent — eventually edging their way into the daytime routine.
Symptoms and Causes Enlarged Prostate Treatment Delhi NCR
In men, urine flows from the bladder through the urethra. BPH is a benign (noncancerous) enlargement of the prostate that blocks the flow of urine through the urethra. The prostate cells gradually multiply, creating an enlargement that puts pressure on the urethra through which urine and semen exit the body.
As the urethra narrows, the bladder has to contract more forcefully to push urine through the body.
Over time, the bladder muscle may gradually become stronger, thicker, and overly sensitive; it begins to contract even when it contains small amounts of urine, causing a need to urinate frequently. Eventually, the bladder muscle cannot overcome the effect of the narrowed urethra so urine remains in the bladder and it is not completely emptied.
Symptoms of an enlarged prostate treatment delhi can include:
- A weak or slow urinary stream
- A feeling of incomplete bladder emptying
- Difficulty starting urination
- Frequent urination
- Urgency to urinate
- Getting up frequently at night to urinate
- A urinary stream that starts and stops
- Straining to urinate
- Continued dribbling of urine
- Returning to urinate again minutes after finishing
When the bladder does not empty completely, you become at risk for developing urinary tract infections. Other serious problems can also develop over time, including bladder stones, blood in the urine, incontinence, and acute urinary retention (an inability to urinate). A sudden and complete inability to urinate is a medical emergency; you should see your doctor immediately. In rare cases, bladder and/or kidney damage can develop from BPH.
Deciding Enlarged Prostate Treatment Delhi NCR
A range of treatments can relieve enlarged prostate symptoms — medications, minimally-invasive office procedures, and surgery. The best one for you depends on your symptoms, how severe they are, and whether you have other medical conditions.
Medications for an Enlarged Prostate Treatment Delhi NCR
Minimally Invasive Enlarged Prostate Treatment Delhi NCR
When medications don’t help your enlarged prostate, several procedures can relieve symptoms — without surgery. They are performed in a doctor’s office. “These procedures use various types of heat energy to shrink a portion of the prostate,” explains Westney. “They are very effective.”
Types of Surgery
TURP (transurethral resection of the prostate): This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.
Transurethral resection of the prostate (TURP). Your doctor removes portions of the prostate that are affecting your urinary flow. This is the most common surgical procedure for BPH and remains the gold standard of interventional treatment options.
There is no cutting and no external scars are seen since a scope is inserted through the urethra to remove the excess tissue.
With TURP, some men might get what’s called “retrograde ejaculation,” (ejaculation of semen into the bladder instead of through the urethra).
Laser Surgery: This procedure uses a high energy vaporizing laser to destroy prostate tissue. It is done under general anesthesia and may require an overnight stay at the hospital. It provides immediate relief of symptoms, yet men may suffer from painful urination for a few weeks. In general, this procedure causes less blood loss, and side effects can include retrograde ejaculation.
For many years, transurethral resection of the prostate (TURP) has been accepted as the gold standard to surgically alleviate obstructive voiding dysfunction in men with benign prostatic hyperplasia (BPH). This historical standard has been challenged repeatedly over the last decade by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). This review summarizes the literature comparing HoLEP and traditional therapies for BPH that are widely used and have long-term efficacy data, primarily TURP, open prostatectomy (OP), and alternative laser therapies (PVP, ThuLEP, etc).
Results: Patients undergoing HoLEP have greater improvements in post-operative Qmax, greater reduction in post-operative subjective symptom scores, and lower rates of repeat endoscopic procedures for recurrent symptoms at 5-10 year follow up compared with TURP, OP, and other laser therapies. Furthermore, patients undergoing HoLEP benefit from significantly shortened catheterization times, decreased the length of hospital stay (LOS), and fewer serious post-operative complications. In particular, randomized controlled trials (RCT) have demonstrated that HoLEP can be used to resect adenomas greater than 100 grams with equivalent efficacy to open prostatectomy, but with radically decreased morbidity.
Conclusion: Numerous large, RCTs demonstrate HoLEP to be objectively superior to other surgical therapies for BPH. The urologic community should embrace HoLEP as the new gold standard for surgical BPH therapy, especially in men with large prostates who would otherwise be considered for an OP or staged TURP. The only obstacle to widespread implementation of HoLEP remains its difficult learning curve when compared with traditional transurethral resection. Further allocation of resources towards appropriate mentoring and teaching of HoLEP is warranted, particularly in residency training programs.
Keywords: HoLEP, holmium, laser, enucleation, benign prostatic hyperplasia, transurethral resection of prostate, open prostatectomy
HoLEP is poised to replace TURP as the standard, based on years of data that consistently demonstrate equivalent or superior outcomes with fewer post-operative complications and longer durability based on re-operation rates. There is an abundance of level 1 data directly comparing outcomes and complications for HoLEP and TURP. it was the only endoscopic procedure to do so. Regarding durability, HoLEP was the only procedure that did not require re-operation for adenoma regrowth within 5 years.
An argument against HoLEP is that operative times are significantly longer than with TURP. Post-operative complications tend to be lower for HoLEP compared to TURP, and post-HoLEP TUR syndrome has never been reported-even for adenomas hundreds of grams in size
HoLEP and OP
Since the origin of HoLEP in the early 1990s, it has revolutionized the surgical treatment of men with large prostates. Men with adenomas deemed too large to resect endoscopically are often advised to undergo open prostatectomy-a surgery associated with high transfusion rates, lengthy catheterization times, and hospital stays averaging as many as 5.4-10 days
Contrary to TURP, HoLEP is a size-independent procedure. The consequence of this is that HoLEP will eventually make OP all but a historical operation for even the largest of prostates. HoLEP has been used to successfully enucleate adenomas as large as 800 g . Numerous well-designed studies have demonstrated that HoLEP outcomes, catheterization time, and hospital length of stay are independent of pre-operative TRUS volume.
Based on all available evidence, HoLEP offers patients a safer, more efficient, and at least equally efficacious, if not more efficacious, treatment for BPH related LUTS when compared to other surgical therapies. When compared with TURP, currently the reference gold standard, patients undergoing HoLEP benefit from a shorter catheterization time, shorter hospital LOS, and fewer complications.
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