Benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate, is a common condition characterised by a non-cancerous enlargement of the prostate in men over 45 years of age. The degree to which the prostate grows varies from person to person. As it enlarges, it can narrow the urethra and cause difficulty with urination. Complications arising from this problem include recurrent urinary tract infections, bladder stones, bladder or kidney damage, and other urinary difficulties.
It is important to be watchful of the symptoms and to visit a urologist when you experience them frequently. Depending on the severity, they can recommend a suitable treatment option.
What Are the Symptoms of an Enlarged Prostate?
The symptoms of an enlarged prostate vary in severity. They often start slowly and progress over time. Common signs include the following:
- Frequent urination, or the feeling of needing to urinate more often than usual, especially during the day
- A sudden or strong urge to urinate that is difficult to control or delay
- Increased frequency of urination during the night
- A less forceful flow of urine
- Difficulty starting urination, or a delay between trying to urinate and the flow beginning
- An intermittent flow that starts and stops several times
- A need to push or strain to empty the bladder
- Leaking of urine after finishing
- A feeling of incomplete bladder emptying even after urinating
How Is an Enlarged Prostate Diagnosed?
An enlarged prostate should be diagnosed in its early stages because, for some patients, it can lead to bladder or kidney damage, urinary tract infections or incontinence if left untreated. Besides discussing the symptoms you have been experiencing, the urologist may confirm the diagnosis in the following ways.
Urine Flow Study
This test measures the flow of urine using a special device. A reduced flow rate is commonly associated with BPH.
Digital Rectal Examination
A gloved finger is inserted into the rectum to feel the back of the prostate. It is usually done to check for any lumps or irregularities.
Prostate-Specific Antigen (PSA) Blood Test
Elevated levels of PSA in the blood may occur due to an enlarged prostate or prostate cancer.
Cystoscopy
A thin tube with a tiny camera is inserted through the opening of the urethra at the tip of the penis. The camera allows the physician to inspect the inside of the prostate, bladder and urethral channel.
Transrectal Ultrasound and Prostate Biopsy
The doctor may order this test if prostate cancer is suspected. An ultrasound probe is used to obtain images of the prostate and to guide a biopsy needle into the gland to collect a small piece of tissue for further examination. This test may also be used to assess the size of the prostate and to plan surgery if it is found to be enlarged.
Prostate Magnetic Resonance Imaging (MRI)
The doctor may suggest an MRI to obtain detailed views of the entire prostate with soft-tissue contrast.
How Is an Enlarged Prostate Treated?
If the test results suggest an enlarged prostate, the urologist will devise a treatment plan based on the severity of the condition. There are various effective treatment options available, including the following.
Medications
Several types of medication may be prescribed to help manage the symptoms of this condition.
- Alpha-blockers: These help relax the muscles in the prostate and bladder neck, making it easier to urinate.
- 5-alpha reductase inhibitors: These may be prescribed to shrink the prostate gland over time.
- Combination therapy: In some cases, the urologist may prescribe a combination of medications to help control the symptoms.
Minimally Invasive Procedures
If medications do not improve the symptoms, or if your symptoms are moderate to severe, the urologist may choose from the following treatment options.
- Transurethral Microwave Thermotherapy (TUMT): This procedure uses microwave energy to heat and destroy excess prostate tissue.
- Transurethral Needle Ablation: This procedure uses radiofrequency energy to ablate excess prostate tissue.
- Water Vapour Thermal Therapy: This treatment uses controlled water-vapour injections to reduce the enlarged tissue.
- Prostatic Urethral Lift: The urologist places small implants to lift and hold the enlarged prostate tissue away from the urethra.
- Temporary Implantable Nitinol Device: A temporary device is placed in the urethra to improve the flow of urine and reshape the prostate tissue.
Surgical Procedures
If minimally invasive methods are not suitable, or if your condition has advanced, the urologist may perform one of the following surgical procedures:
- Transurethral Resection of the Prostate (TURP): This traditional surgery removes excess prostate tissue through the urethra.
- Holmium Laser Enucleation of the Prostate (HoLEP): Laser energy is used to remove or ablate excess prostate tissue.
- Simple Prostatectomy: The surgeon performs an open or robotic procedure to remove the inner part of the prostate gland.
Takeaway
An enlarged prostate can become an alarming condition when it reaches an advanced stage. It is, therefore, essential to be watchful of the symptoms and to visit a urologist promptly as you begin to experience them. The specialist may treat the condition using minimally invasive options or surgical procedures. To learn more about the newer procedures available, see our guide to modern treatments for an enlarged prostate.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs. If you have symptoms or a question about your health, book a consultation with Dr. Anish Gupta.