Prostate Enlargement
Benign prostate syndrome is a common condition in our elderly population, the prime cause of which is an enlarged prostate compressing the urethra and reducing the flow of urine.
Clinical significance comes with symptoms such as a weakened stream of urine, frequent urination at night, residual urine up to urinary retention, kidney obstruction, urinary tract infections, and bladder stones. The risk of developing BPS increases with age. It affects 10-20% of men in their fifties and 20-35% of men in their sixties to seventies. Its likelihood of occurrence approaches nearly 100% for men over 90.
The prostate is a gland found just below the bladder and surrounding the urethra. It produces fluid to help nourish and transport sperm. Testosterone and genetic factors are critical in the development of an enlarged prostate.
The prostate enlarges and starts to press against the urethra, leading to problems while passing urine. Symptoms at early stages of BPS include excessive urination, especially during nighttime, with a sensation of having to go right away.
Symptoms of a thinning stream of urine, difficulty initiating urination, dribbling, or a sensation of incomplete emptying increase with the progression of the disease. Severe BPS may even lead to urinary retention, infections, blockage of the kidneys, and bladder stones, requiring treatment. Diagnosis of BPS is gathered from meticulous history, standardized questionnaires, physical and ultrasound examinations, and assessments of urine flow and residual urine. Further assessments may be done through laboratory studies and endoscopic procedures.
When BPS is significant, medical treatment is commonly the initial prescription. When medical treatment is unsuccessful or when BPS is severe surgery to reduce the size of the prostate gland is indicated. We have all the possible surgical options in accordance with the size of the prostate and the overall condition of the patient’s health. Endoscopic procedures, such as TUR-P, ThuLEP, HoLEP and REZUM®, allow for minimally invasive treatment of the prostate.
