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What is BPH - Benign prostatic hyperplasia?
Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a proliferation (multiplication) of the cellular elements of the prostate, leading to an enlarged prostate gland.
What causes the Prostate to enlarge?
Enlargement of Prostate (also known as Benign Prostatic Hyperplasia) occurs when the cells of the gland begin to multiply. This multiplication makes the gland grow larger in size and squeeze the urethra, limiting the flow of urine.
How is Prostate Enlargemnent diagnosed?
What are the symptoms for Prostate Enlargemnent?
When the prostate enlarges, it may constrict the flow of urine. Nerves within the prostate and bladder may also play a role in causing the following common symptoms:
Urinary frequency - Increased in number of micturition
Urinary urgency - urge to pass immediately after getting the sensation of urination
Nocturia - Needing to get up frequently at night to urinate
Hesitancy - Difficulty initiating the urinary stream; interrupted, weak stream
Incomplete bladder emptying - The feeling of persistent residual urine, regardless of the frequency of urination
Straining - The need strain or push to initiate and maintain urination in order to more fully empty the bladder
Decreased force of stream - The subjective loss of force of the urinary stream over time
Dribbling - The loss of small amounts of urine due to a poor urinary stream as well as weak urinary stream.
When should you see a doctor?
If you are having trouble urinating, it is generally advisable to visit a urologist. Even though the cause might not be prostate enlargement, it’s important to identify the underlying causes and address them.
Is Prostate Enlargement always cancerous?
No, in most cases, prostate enlargement is caused by Benign Prostate Hyperplasia (BPH). This is a condition that shows up in a very high % of men with age, with almost one-third of men experiencing moderate to severe symptoms by the age of 60. BPH is not linked to cancer and does not increase the risk of getting it.
What are the complications of BPH?
BPH may lead to Chronic bladder outlet obstruction (BOO) which in turn leads to urinary retention, impaired kidney function, recurrent urinary tract infections, gross hematuria(Blood in urine), and bladder calculi (stones).
How serious is an enlarged prostate?
While an enlarged prostate can be quite common and doesn’t post any immediate serious complications, in the long term, it can result in complications that include Urinary Tract Infections (UTI), Bladder Stones as well as Bladder or Kidney Damage. In case you have been diagnosed with an enlarged prostate, you should immediately consult a urologist.
How is it Diagnosed and what are the tests done ?
Digital rectal examination
The digital rectal examination (DRE), the examiner can assess prostate size and contour, evaluate for nodules, and detect areas suggestive of malignancy.
Urinalysis - Examine the urine to assess for the presence of blood, leukocytes, bacteria, protein, or glucose
Urine culture - This may be useful to exclude infectious causes of irritative voiding and is usually performed if the initial urinalysis findings indicate an abnormality
Prostate-specific antigen (PSA) - as a screening test for prostate cancer.
Electrolytes, blood urea nitrogen (BUN), and creatinine - to check for any kidney damage secondary to BPH
Ultrasonography - USG
Ultrasonography is useful for helping to determine bladder, prostate, and kidney injury.
Endoscopy of the lower urinary tract - Cystoscopy.
Cystoscopy may be indicated in patients scheduled for invasive treatment or in whom a foreign body or malignancy is suspected. In addition, endoscopy may be indicated in patients with a history of sexually transmitted disease (eg, gonococcal urethritis), prolonged catheterization, or trauma.
Other tests like Flow rate, PVR urine volume, Pressure-flow studies etc., depending on the degree of BPH.
What is the management (treatment) ?
Alpha-adrenergic receptor blockers
5-alpha reductase inhibitors
Phosphodiesterase-5 enzyme inhibitors
Transurethral resection of the prostate (TURP) - Part of prostate is resected via urethra (urine pipe) to relieve the obstruction.
Open prostatectomy - Reserved for patients with very large prostates (>75 g), patients with concomitant bladder stones or bladder diverticula, and patients who cannot be positioned for transurethral surgery
Minimally invasive treatment
Transurethral incision of the prostate (TUIP)
Laser treatment - Used to cut or destroy prostate tissue; multiple laser types are available - used as per surgeons discretion.
Transurethral microwave therapy (TUMT) - Generates heat that causes cell death in the prostate, leading to prostatic contraction and volume reduction
Transurethral needle ablation of the prostate (TUNA)
Prostatic stents - Flexible devices that expand when put in place to improve the flow of urine past the prostate
Implanted devices to relieve prostatic obstruction (eg, UroLift)
What is laser surgery procedure?
Is there any treatment for prostate cancer?
What all procedures does Ayu Health offer for Prostate related treatments?
Ayu Health offers a range of procedures for Benign Prostatic Hyperplasia (BPH) as well as Prostate Cancer. If you are having any symptoms of either, it is highly recommended to book an appointment today with a urologist.
Call us for booking an appointment with us