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Summary

As men age, the prostate starts enlarging, making it difficult to urinate. The medical term for enlarged prostate gland is Benign Prostatic Hyperplasia (BPH). Symptoms of BPH include non-emptiness in the bladder even after urinating and unstreamed urine flow. BPH is quite common, with some studies claiming that upto one-third of men report moderate to severe symptoms of BPH by the age of 60.

In some cases, prostate enlargement can happen due to multiplication of cells that turn malignant, resulting in Prostate Cancer.

What is Prostate?

The prostate is a very small sized reproductive gland that usually weighs near 30 gms and sits just under the bladder, near the urethra. The prostate is found only in men. It excretes a fluid that contributes 30% of the semen. It protects the sperm for a longer life span and makes thick sperms thin to make it flow smoothly and able to fertilize the egg more efficiently.

What causes prostate enlargement or cancer?

In some people, the tissue around the prostate or the prostate cells themselves start multiplying. This causes the prostate to become enlarged. When the multiplying cells are malignant, it results in prostate cancer.

Symptoms / when to call your doctor

Some of the symptoms are:

  • Frequent urination

  • Urgency in urination

  • Incontinence

  • Blood in semen

  • Erectile dysfunction

Why you should see a doctor?

If you experience any of the symptoms of prostate enlargement, you should see a doctor immediately. Ignoring the symptoms may lead to:

  • Urinary tract infection

  • Kidney and bladder damage

  • Kidney stones

  • If the cause is cancer, leaving it untreated can be life threatening

How is it diagnosed?

To diagnose an enlarged prostate, the doctor may recommend:

  • Blood tests

  • Urine tests

  • Digital rectal exam

Dietary Restrictions

After the surgery, you should eat foods that are easy on the digestive system. Eating small, frequent meals helps.

Some of the foods that you can include in the diet are:

  • Soups and juices

  • High fibre food

  • Fruits and vegetables

  • Low fat food is advised

  • Avoid fried, sugary and processed food

Treatment for Benign Prostatic Hyperplasia (BPH)

The doctor will recommend the required treatment based on the findings from the tests and examinations. In case just medication isn’t sufficient to treat the condition, the doctor might recommend a surgical procedure. The aim of the surgery is to remove the central glandular part of prostate which relieves obstruction of the urethra.

There are a few different types of surgical procedures for treating BPH:

Transurethral Resection of the Prostate (TURP)

Procedure Flow

TURP involves insertion of a slender instrument (resectoscope) is inserted up the urethra. An electrical current is passed through the resectoscope’s wire loop to shave away sections of enlarged prostate. Shaved prostate tissue is flushed into the bladder and removed through the resectoscope. TURP is the most common surgery for BPH, accounting for 9 out of 10 procedures.

Recovery Time and Dietary Advice:

  • 2-3 day hospital stay

  • Resume normal routine after 2-6 weeks, depending on your job profile

  • A catheter is placed for 1-2 days

  • Drink plenty of water after surgery (about 8 glasses per day)

  • Eat high fibre foods, avoid constipation

Risks involved in the treatment:

While the procedure is generally safe, it does carry certain risks.

  • Allergic reaction to anaesthesia

  • Short term nausea or vomiting

  • Painful urination that can last for a few weeks

  • Temporary sexual dysfunction

Transurethral Incision of the Prostate (TUIP)

Procedure Flow

TURP involves using a resectoscope to make small incisions around the prostate and neck of the bladder. This releases the narrowing at the bladder neck and enlarges the urethra. No prostate tissue is removed. TUIP is suitable for men with smaller prostate enlargements.

Recovery Time and Dietary Advice:

  • 2-3 day hospital stay

  • Resume normal routine after 2-6 weeks, depending on your job profile

  • A catheter is placed for 1-2 days

  • Drink plenty of water after surgery (about 8 glasses per day)

  • Eat high fibre foods, avoid constipation

Risks involved in the treatment:

While the procedure is generally safe, it does carry certain risks.

  • Allergic reaction to anaesthesia

  • Short term nausea or vomiting

  • Painful urination that can last for a few weeks

  • Temporary sexual dysfunction

Laser Surgery

Procedure Flow

During prostate laser surgery, a scope is inserted through the tip of penis into the tube that carries urine from the bladder (urethra). Laser is passed through the scope to deliver energy (through concentrated light and heat) to remove excess tissue that is preventing the urine flow.

While there are a few different types of laser surgeries available for treating BPH, the exact treatment is best determined by the doctor.

Laser surgery has various advantages over other methods of treating BPH, namely

  • Shorter stay - 24 hour hospitalization for most cases

  • Faster recovery

  • Lower risk of bleeding

  • Most cases do not require using a catheter beyond 1-2 days

  • More immediate results

Risks involved in the treatment:

A laser surgery involves similar risks as other BPH procedures.

Treatment for Prostate Cancer

In case of cancerous growth of prostate, the doctor might recommend partial or complete removal of the prostate, also known as prostatectomy.

Types of surgeries:

SpecificsRadical Prostatectomy - Robot-assistedRadical Prostatectomy - Open SurgeryRadical Prostatectomy - LaparoscopicSimple Prostatectomy
IncisionSmall8-10 inchSmall8-10 inch
Blood LossLessHighLessHigh
Recovery timeFasterLongerFasterLonger
InvasiveNoYesNoYes

Radical Prostatectomy

Radical prostatectomy is done to completely remove the prostate gland along with the surrounding tissues.

Robotic Radical Prostatectomy

In this procedure, a tiny robot is inserted through an incision to remove the prostate.

Flow of the procedure:

  • Patient is given general anaesthesia for the procedure

  • Small incisions are made in the abdomen

  • A tiny robot is inserted into the incision

  • The camera footage is visible on a screen which guides the doctor to perform the surgery

  • The prostate is removed through one of the incisions

  • The incisions are taped and the patient is taken to the recovery room

Recovery Time and Dietary Advice:

  • 1- 3 days hospital stay with mild pain

  • Resume to normal routine after 2-3 weeks

  • Simple, bland, nutritious, fibre rich food

There are very less complications through this treatment. Some of the risks may be:

Some of the risks of the procedure may be:

  • allergic or adverse reaction to anaesthesia or other drugs

  • bleeding

  • infection

  • injury to adjacent organs

  • urinary incontinence

  • erectile dysfunction

Laparoscopic Radical Prostatectomy

In this procedure, a camera is inserted through a small incision made in the abdomen though which the prostate is removed.

Flow of the procedure:

  • Patient is given general anaesthesia for the procedure

  • Small incisions are made in the abdomen

  • A tiny camera is inserted into the incision

  • The camera footage is visible on a screen which guides the doctor to perform the surgery

  • The prostate is removed through one of the incisions

  • The incisions are taped and the patient is taken to the recovery room

Recovery Time and Dietary Advice:

  • 1- 3 days hospital stay with mild pain

  • Resume to normal routine after 2-3 weeks

  • Simple, bland, nutritious, fibre rich food

There are very less complications through this treatment. Some of the risks may be:

Some of the risks of the procedure may be:

  • allergic or adverse reaction to anaesthesia or other drugs

  • bleeding

  • infection

  • injury to adjacent organs

  • urinary incontinence

  • erectile dysfunction

  • bowel injury

Open Radical Prostatectomy

This is an open surgery in which the prostate is removed directly from a large incision made in the lower abdomen.

Flow of the procedure:

  • Patient is given general anaesthesia for the procedure

  • A large incision is made in the abdomen

  • The doctor reaches into the lower abdomen and removed the prostate

  • The incision is sutured and the patient is taken into the recovery room

Recovery Time and Dietary Advice:

  • 2- 3 days hospital stay

  • Resume to normal routine after 2-4 weeks

  • Simple, bland, nutritious, fibre rich food

Risks involved in the treatment:

Some of the risks of the procedure may be:

  • allergic or adverse reaction to anaesthesia or other drugs

  • bleeding

  • infection of the cut

  • injury to adjacent organs

  • urinary incontinence

  • narrowing of the urethra

Simple Prostatectomy

This procedure is used to remove only parts of the prostate through a large incision made in the lower abdomen.

Flow of the procedure:

  • Patient is given general anaesthesia for the procedure

  • A large cut is made in the abdomen

  • The doctor removes parts of the prostate through the cut

  • The cut is sutured and the patient is taken to the recovery room

Recovery Time and Dietary Advice:

  • Hospital stay of 2-4 days or longer

  • Resume normal day routine after 6 weeks

  • Light food which can be easily digested

  • Avoid foods that make you gassy like cauliflower, broccoli, beans etc

Risks involved in the treatment:

The procedure involves a large cut. So, some of the risks may be:

  • Injury to surrounding organs

  • Infection

  • Excessive bleeding

  • Breathing difficulties

  • Heart attack or stroke during surgery

  • Blood clots related to the longer recovery period after open surgery

  • Risks of general anaesthesia