The commonest cause of an enlarged prostate is usually BPH (Benign prostatic hyperplasia). Moreover, the American Urological Association (AUA) estimates that over 50% of men over 50 would develop BPH. Thus, you must understand that prostate enlargement is a fairly common by process in all men due to natural ageing.
Symptoms of prostate enlargement
In my clinical practice as a urologist, I have seen and treated numerous patient’s with benign prostatic hyperplasia.
Interestingly, the most common complaint I get from patients is that
“Doctor, I keep losing my sleep in the night, I feel like passing urine despite emptying my bladder. Most of the time I end up going to urine at least 3 to 4 times”
Some patients also come to my practice with symptoms as outlined below:
- Difficulty in starting their urination
- Poor urine flow
- A feeling of incomplete emptying of the bladder
- Urination that frequently stops and begins
Diagnosis of an enlarged prostate or BPH
Most men, unfortunately, end up tolerating an enlarged prostate for years before visiting a urologist. The most important fact to bear in mind though is that, urinary problems do not occur just due to an enlarged prostate. The presence of kidney stones, bladder problems can all lead to difficulties in urination and also urinary incontinence Thus, the diagnosis of BPH is usually a diagnosis of exclusion.
We first rule out all the common conditions that lead to difficulty in passing urine, before concluding on a prostate problem. We also use the BPH impact index, a set of clinical tools that can help us assess to what extent does your prostate problem interfere with your day to day life. This tool was developed by the American Urological Association (AUA).
The most important thing is that, you may have an enlarged prostate but may not have any voiding symptoms at all!
The truth is..
Prostate enlargement and its treatment needs to be individualized depending on the patient’s voiding pattern and symptoms! Most of the time, I would advice patients who come to me with minor symptoms to “wait and watch” and get checked periodically.
Prostate enlargement treatment options
There are various treatment options for an enlarged prostate. The truth is, only a few of them are recommended and actually work!.
The choice of a particular treatment depends on your age, the extent of your symptoms and lastly the presence of associated health conditions.
Lets briefly go through each of them..
Medical therapy for the enlarged prostate:
A category of drugs popularly used to treat an enlarged prostate is called alpha blockers. These drugs include medications like tamsulosin, alfuzosin and doxazusin.
These drugs ultimately help in relaxing the muscle fibers in the prostate and around the urethra, thus helping in urination. Your urination can improve in as early as one day post taking in the medication.
The next type of medication is called 5 alpha reductase inhibitors. This group of medication involves drugs like Finasteride and Dutasteride. These medications exert a therapeutic benefit by blocking the action of free testosterone.
The prostate gland eventually may reduce in size when you take it for a period of 90 to 180 days. The disadvantage though is that you may experience a loss or decrease in your erectile function. Sometimes a combination treatment regimen of finasteride and dutasteride can work better vs a single medication alone.
Surgical management of enlarged prostate
The most commonly done surgical technique world over is called TURP (Transurethral resection of the prostate).
The procedure requires anesthesia but allows quick patient recovery and excellent permanent relief of all urinary problems. In a similar technique called TUIP (Transurethral incision of the prostate), the tissue is not actually removed but numerous incisions are placed in the prostate, thereby relieving urine flow.
HOLEP Surgery using laser:
In this technique, a Holmium YAG laser is used to vaporize the excess prostate tissue. This technique allows excellent patient recovery and also has minimal blood loss. At our urology hospital in Chennai, we routinely perform Holep surgeries for patients where required.
So, that’s about it!
I hope you enjoy reading this short article on BPH. If you are suffering from voiding problems and need help, get in touch with us below!