Prostate gland enlargement or Benign Prostatic Hyperplasia (BPH) is a commonly found problem in males as old age sets in. This is an uncomfortable and irritable condition that may worsen as one gets older. The easily recognisable symptom of BPH is problem in passing urine. Due to the prostate enlargement a block in urethra is caused over time. The tube that helps take the urine from the bladder to the urethra goes through the prostate. The blockage in the urethra would mean more pressure on the prostate. Urinating more frequently is a common problem seen during these times. It is observed that BPH is commonly seen in at least 50 per cent of men who are above the age of 50 and around 90 per cent of men who are above the age of 80 have to suffer from this condition.

Common symptoms

  • Urinary tract infection
  • Frequent need to urinate especially at night
  • Inability or difficulty starting a urine stream
  • A slow or broken urinary stream
  • Urgency to urinate
  • Feeling of bladder not completely emptied
  • Blood in urine

Indicators

Though the exact cause is still unknown, family history and also changes happening in the male sex hormone are cited as primary factors. The indicators of BPH can be attributed to:

  • Infections in the urinary tract
  • Stones in kidney or bladder
  • The onset of prostate cancer
  • Inflammation of the prostate

Complications and Treatment decisions

It is not advisable to prolong undergoing treatment for prostate enlargement. But most men delay visiting a doctor and do not seek medical advice for a long time. Regular tests are one way to know in advance about the possible risks and onset of BPH. When detected and diagnosed early, interventions can help reduce further complications and major risks as one gets older. If not diagnosed early and if treatment or any medical intervention is delayed, the future complications may include:

  • Severe urinary tract infections
  • Acute urinary retention or inability to urinate
  • Bladder damage and bladder stones
  • Damage to the kidneys

If any causes mentioned earlier are observed, it is recommended that one visits the doctor and takes medical advice.

Treatments and Surgeries-

If general interventions, lifestyle changes and medications do not work, other surgical interventions and treatment methodologies are considered as an option.

TURP (Transurethral Resection of the Prostate)

In this procedure, a resectoscope is used to pass through the urethra. The resectosope has a viewing lens at one end. This helps in visualising the prostate. A video monitor connected to the equipment allows magnified display of the surgical process. During the procedure, a part of the prostate gland is carved that allows the urethra to its original level. TURP is a quick procedure that relieves the symptoms. Complications may include- bleeding, infection, retrograde ejaculation and impotence.

TUERP (Transurethral Enucleation and Resection of the Prostate)

A bipolar plasma kinetic resectoscope is used to transurethrally enucleate and resect the prostate in Transurethral enucleation and Resection of the Prostate (TUERP). It has been a proven procedure with minimal complications and side effects and considered as a safer solution for BPH. It takes shorter procedural time as compared to TURP. In this procedure the gland can be completely enucleated and resected using laser or electric energy. The adenoma is dissected along the surgical capsule. The adenoma can be completely removed and not just a partial surface. The relapse rate is lower in TUERP, saves operative time and is more efficient.

Post-treatment

Following care has to be taken post-treatment.

  • A catheter would be connected for a day after the surgery.
  • Take ample rest with some movements.
  • Do not strain or over exert.
  • Avoid exercises for 6-8 weeks.
  • Do not lift weights for some period of time.
  • Consume water in large quantities.
  • Avoid sitting posture for more than 30 minutes at a stretch.
  • Cases of impotence or retrograde ejaculation may be noted in some cases.