WHAT IS ENLARGED PROSTATE?

An enlarged prostate is also known as Benign Prostate Hyperplasia (BPH). The prostate is a gland present near urinary tract in males. Size of prostate gland increases as the person gets older because of the altered balance of sex hormones.

Symptoms of enlarged prostate appear when an increase in prostate gland presses the urethra. Symptoms of an enlarged prostate are generally related to urination which includes:

SYMPTOMS

  • Frequent urination especially at night
  • Difficulty in starting urination
  • Incomplete emptying of the bladder 
  • Urgent need for urination
  • Weak urine stream 
  • Dribbling

DIAGNOSIS

Diagnosis is usually made after appearance of LUTS(above). The doctor does an examination along with.

  • Urine test 
  •  Uroflowmetry
  •  Urinary flow test 
  •  Prostate-specific antigen (PSA)
  • Ultrasound KUB & PVRU

TREATMENTS DEPENDS ON SIZE OF THE PROSTATE & SEVERITY OF SYMTOMS.

The treatment for enlarged prostate depends on the size of the prostate and the severity of the symptoms.

Medicines

Medicines are used to slow the growth of the prostate, or to manage the urinary symptoms. Medicines can be prescribed for long terms as long as they provide relief from symptoms. If the patient doesn’t get relief by using medicines or the symptoms again start after taking medicines for longer duration, he may be advised surgical removal of the prostate gland.

Surgery

Surgery is usually advised to patients who have moderate to severe symptoms and do not get relief with medication, or have a grossly enlarged prostate gland (>80cc).

The various types of surgeries available for enlarged prostate are;

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TURP (Transurethral Resection of the Prostate)

A combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The prostate surrounds the urethra. Using the resectoscope, your doctor trims away excess prostate tissue that’s blocking urine flow. Traditionally, TURP has been considered the most effective treatment for an enlarged prostate. However, a number of other, minimally invasive procedures are becoming more effective, due to improved techniques and surgical tools. These minimally invasive procedures generally cause fewer complications and have a quicker recovery period than TURP.

HoLEP (Holmium Laser Enucleation of the Prostate)

Holmium Laser Enucleation of the prostate (HoLEP) is a modern, minimally invasive alternative to the standard Transurethral Resection of the Prostate (TURP) procedure for bladder outflow obstruction due to BPH. The procedure uses a laser to remove tissue that is blocking urine flow through the prostate. A separate instrument is then used to cut the prostate tissue into easily removable fragments. HoLEP is considered generally safer than TURP due to lesser bleeding and earlier recovery. The need for repeating the procedure is also significantly less as compared to TURP.

(THULVP) Thulium Laser Vaporisation of the Prostate

Thulium Laser Vaporisation of the Prostate is a procedure similar to HoLEP, but uses a high power Thulium Laser instead. The laser vaporises prostatic tissue leading to minimal bleeding and extremely quick recovery times. The patient can be discharged the next day after procedure. The procedure is currently the best available surgical treatment for Enlarged Prostate. The availability of Thulium Laser surgery is very less due to high cost of the laser which makes it exclusive to a few centres.