Enlarged prostate, also known as benign prostatic hyperplasia (BPH) or prostatomegaly, occurs when the prostate gland becomes larger than its usual size.
When the prostate grows large, it can cause difficulties, including kidney stones, passing urine, and ejaculating through the urethra. It's important to note that BPH itself is not cancerous, but experiencing symptoms associated with BPH could indicate the presence of prostate cancer and other more serious conditions. In this blog, you will learn about the diagnosis, treatment, and prevention of enlarged prostate, but first, let’s discuss its common symptoms.
Symptoms of Benign Prostatic Hyperplasia
Common symptoms associated with prostate enlargement include:
- Urgent or frequent need to urinate: This means feeling a strong need to urinate more often than usual.
- Incomplete emptying of the bladder: This refers to the sensation of not being able to empty the bladder after urination.
- Difficulty initiating urination: This refers to trouble starting the urine flow when urinating.
- Weak urine stream: This describes a reduced force of urine flow, often with interruptions.
- Post-void dribbling: This involves experiencing leakage or dribbling of urine after completing urination.
- Nocturia: This refers to the need to wake up frequently during the night to urinate.
Less common symptoms may include:
- Presence of blood in the urine: Pinkish or reddish blood in the urine.
- Urinary tract infections (UTIs): These can occur due to incomplete bladder emptying, leading to bacterial growth and infection.
- Urinary retention: This is a severe condition where the individual is unable to urinate despite feeling the urge to do so.
It's important to note that the severity of symptoms in BPH can vary regardless of the size of the prostate. Some individuals with only a slight enlargement may experience significant symptoms, while others with a larger prostate may have fewer or less severe problems. Additionally, some people with enlarged prostates may not experience any symptoms at all. Reporting any symptoms, however big or small, to your urologist is recommended for appropriate benign prostate enlargement treatment.
Diagnosis of Benign Prostatic Hyperplasia
The best urologist in Delhi initiates the diagnostic process by questioning the patient about their symptoms and performing a physical examination, which may include:
- Urine test: Analysis of the urine sample in a laboratory to detect any underlying illnesses or conditions that may present similar symptoms to BPH.
- Digital rectal exam: A finger test into the rectum to assess the size of the prostate gland.
- Blood test: A kidney function test to identify and rule out abnormalities in the blood.
Following the initial assessment, further tests may be required to confirm an enlarged prostate, such as:
- Prostate-specific antigen (PSA) blood test: Elevated levels of PSA can indicate prostate enlargement, although other factors like recent medical procedures, illnesses, or prostate cancer may influence the results.
- Postvoid residual volume test: This examination measures the amount of urine left in the bladder after urination, often conducted using ultrasound or a catheter.
- Urinary flow test: This test measures the strength and volume of urine passed, providing insights into the condition's progression over time.
In cases where the condition is more complex, additional tests may be necessary, including:
- Transrectal ultrasound: This procedure employs sound waves to generate images of the prostate, aiding in its measurement and assessment.
- Prostate biopsy: Tissue samples are obtained from the prostate for analysis, assisting in the ruling out or diagnosis of prostate cancer.
- Urodynamic and pressure flow studies: A catheter is inserted through the urethra into the bladder to evaluate bladder pressure and muscle function, typically involving water or air in the bladder.
- Cystoscopy: This involves the insertion of a flexible, illuminated tool into the urethra to visualise the bladder and urethra.
Benign Prostatic Hyperplasia Treatment
There is no cure for enlarged prostate, but there are several treatment options addressing the symptoms. The therapy for enlarged prostate depends on the severity of symptoms, and the individual's age and overall health, and the size of the prostate. The best urologists in Delhi and India recommend the following common enlarged prostate treatments:
1. Watchful waiting
If symptoms are mild or not bothersome, your doctor might recommend regular check-ups to monitor the condition without immediate treatment.
2. Medications
Medications are the first line of treatment for prostatomegaly. Urologists may prescribe:
- Alpha-blockers: These medications relax the muscles around the prostate and bladder, making urinating easier. Examples include tamsulosin, alfuzosin, and terazosin.
- 5-alpha reductase inhibitors: These medications can help shrink the prostate gland by blocking the production of certain hormones. Examples include finasteride and dutasteride.
- Combination therapy: Some individuals may benefit from taking both alpha-blockers and 5-alpha reductase inhibitors at the same time.
3. Lifestyle changes
Certain lifestyle adjustments can help manage symptoms, such as avoiding caffeine and alcohol, practicing pelvic floor exercises (Kegels), and maintaining a healthy weight.
4. Catheterisation
In cases where the patient cannot urinate properly, temporary or permanent catheterisation may be necessary to drain urine from the bladder.
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Enlarged Prostate Surgeries and Procedures
- Transurethral resection of the prostate (TURP): This procedure involves removing excess prostate tissue, leaving the outer prostate as is. It's a common surgical option for BPH.
- Transurethral incision of the prostate (TUIP): Instead of removing tissue, this procedure involves making small cuts in the prostate to relieve pressure on the urethra.
- Prostate laser surgery: Various laser surgeries for enlarged prostate treatment are available. These help reduce prostate tissue and alleviate symptoms.
- Open prostatectomy: In severe cases or when other treatments are ineffective for enlarged prostate problems, open prostatectomy treatment is advised. It involves the use of large cuts in the lower stomach to access the prostate tissue. It is efficient in removing parts or all of the prostate that may be necessary.
- Robot-assisted prostatectomy: Similar to open prostatectomy but performed with the assistance of robotic technology, which can lead to shorter recovery times and less blood loss.
There are also minimally invasive procedures for enlarged prostate, such as prostatic urethral lifts.
Benign Prostatic Hyperplasia Prevention
To reduce the risk of developing BPH, one should focus on lifestyle changes. For instance, engaging in at least 30 minutes of daily exercise is beneficial as a preventative measure. Men should also keep their cholesterol, blood pressure, and blood sugar levels under check.
Several herbal supplements, such as flaxseed, beta-sitosterol, and pumpkin seed oil, may potentially reduce the risk of developing BPH. Before incorporating new supplements, consulting with the best urologist in Delhi is essential.
Conclusion
Benign prostatic hyperplasia is a prevalent condition predominantly affecting individuals assigned male at birth (AMAB), typically manifesting around the age of 55. Regular monitoring of symptoms through routine appointments with doctors may be recommended for those with mild BPH. However, if it begins to impact the quality of life significantly, various treatment options for prostate gland enlargement reduction are available. Individuals experiencing any mild or serious symptoms of BPH should consult the best urologists in Delhi. They can discuss everything from prostate laser surgery costs in India to the benefits of medications. Together with their urologist, patients can collaborate on determining the most suitable treatments for an enlarged prostate.
Disclaimer:
This article has been written for information purposes only, and is not a substitute for professional medical advice by a qualified doctor or other health care professional. The author is not responsible or liable, directly or indirectly, for any form of damages whatsoever resulting from the use (or misuse) of information contained in or implied by the information in this article. Always consult a qualified healthcare provider for accurate diagnosis, personalised treatment, and recommendations tailored to your individual health needs.