Benign Prostate Enlargement

Overview:

Benign Prostatic Enlargement, also known as Benign Prostatic Hyperplasia (BPH), is a common condition characterized by the non-cancerous enlargement of the prostate gland in males.

The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate grows larger, it can lead to urinary symptoms and affect the quality of life. BPH is a common condition among aging males and is not linked to prostate cancer.

Symptoms:

Patients with BPH may experience a range of urinary symptoms due to the enlarged prostate compressing the urethra and bladder. These symptoms can include:

  • Weak Urinary Stream: The flow of urine may be weak, slow, or intermittent.
  • Incomplete Emptying: A feeling that the bladder is not completely empty after urination.
  • Straining: Needing to strain to initiate urination.
  • Dribbling: After urination is complete, there might be dribbling or leaking of urine.
  • Urinary Frequency: Needing to urinate more often than usual, especially during the night (nocturia).
  • Urgency: A sudden and strong urge to urinate, sometimes leading to difficulty in holding back urine.
  • Urinary Retention: In severe cases, there could be difficulty in starting or stopping urination, or even an inability to urinate at all.

Complications:

If left untreated enlarged prostates can lead to urinary tract infections, blood in the urine, bladder stone formation, kidney failure and bladder failure.

Diagnosis:

If you feel you are affected by an enlarged prostate see you doctor. He / She will assess your history and perform a physical examination and arrange suitable investigations such as:

  • Digital Rectal Examination (DRE): A physical examination where the doctor assesses the size, shape, and texture of the prostate gland through the rectum.
  • Urinalysis: A urine test to rule out urinary tract infections and other conditions that could be causing similar symptoms.
  • Prostate-Specific Antigen (PSA) Test: A blood test to measure PSA levels, which can help determine your risk of prostate cancer. An enlarged prostate can elevate the PSA.
  • Ultrasound: Imaging tests such as transabdominal ultrasound can provide visual information about the size of the prostate and its effect on the bladder and kidneys.

Treatment:

Treatment options for BPH depend on the severity of symptoms, the impact on your quality of life, and any complications. These can include:

  • Watchful Waiting: In mild cases, especially if symptoms are not bothersome, regular monitoring might be recommended.
  • Lifestyle Changes: Patients may benefit from avoiding caffeine and alcohol, managing fluid intake, and practicing “double voiding” to ensure the bladder is emptied completely.
  • Medications: Can be used to relax the prostate and base of the bladder; shrink the prostate; and reduce the overactivity of the bladder (frequency, urgency, night time voiding).
  • Minimally Invasive Procedures: Techniques like transurethral resection of the prostate (TURP), laser enucleation of the prostate, REZUM steam treatment, Urolift, prostatic artery embolisation and others can remove excess prostate tissue and improve urine flow.
  • Open or Robotic: Simple prostatectomy

It’s important for patients experiencing urinary symptoms to consult a healthcare professional for proper evaluation and management. BPH is a treatable condition, and appropriate interventions can greatly improve the patient’s quality of life.