The prostate is a gland is a part of the male reproductive system with a fibro muscular structure that surrounds the base of the bladder. With age, the prostate tends to grow in size and the medical term for this occurrence is benign prostatic hyperplasia. The growth of the different structures of the prostate determines the type of prostate adenoma. This is one of the most common benign tumors found in men over 60 years. Due to its localization around the urethra, once the prostate grows in size it can cause problems with urination.
The symptoms for prostate adenoma are the result of the sub bladder obstruction that is a hesitant start of urination, the patient has to wait a while before the urination begins
1. Interrupted or Intermittent flow of urine
2. Difficult urination in which the person struggles to empty his bladder
3. Urine blockage - Long time to urinate due to the week urine flow
4. Pseudo incontinence - because the bladder is too full
5. Nocturia – frequent urination or urges to urinate at night time
6. The imperious urge to urinate, the sensation of urgency to urinate
7. Pain or burn like sensation during urination
From statistics, most men cope with the above symptoms for a long period of time before going to see a doctor, but it is better to visit a doctor and get the right treatment soon. To reach the diagnostics, a general physical examination and a digital rectal examination are the first steps required. Other investigations that are involved are urine analysis and urine flow test. Also, the PSA test is required to give information related to the evolution of the adenoma, but can’t be used on its own to confirm the diagnosis. In some cases, post-void residual test and cystoscopy are requested.
There are several treatment options for patients with prostate adenoma:
Medication, minimally invasive procedures, surgery Etc. The treatment strategy will be decided by the consulting doctor for each patient individually, taking into consideration his general health, age, how big is the prostate and how much disturbance the symptoms provoke.
Usually, alpha blockers (is meant to make the prostate tissue relax) and 5-Alpha (is to cut off the production of the hormones that stimulate prostate enlargement) reductase inhibitors are prescribed. The patient may be prescribed one or the other or a combination of the above two.
Non-invasive treatment options:
TUMT (transurethral microwave thermotherapy) a common procedure performed to treat some of the urinary tract symptoms
TUNA (transurethral radiofrequency needle ablation) is a technique that uses radio frequency energy to eliminate the prostate tissue in excess; - Stents are sometimes inserted in the urethra to eliminate the discomfort of the symptoms, but most of the times is a compromise solution for patients who can’t take medication or don’t want to go to surgery.
TURP (transurethral resection of the prostate) is the most common and recommended of procedures and is also the one that is thought to deliver the best results and success rate
TUIP (transurethral incision of the prostate) a procedure almost identical to the one before, a newer option that presents more benefits
Laser Surgery presents fewer risks post-surgery and a faster recovery for the patient
Prostatectomy is recommended when the adenoma is very big and it is an open surgery that will be performed through an incision while the patient will be under general or spinal anaesthesia.
Prostate enlargement (BPH) can be prevented by:
Changing your lifestyle
Including Yoga in your workout regime
Making dietary changes (foods to avoid and include)
Contact 080 28483939 for more information on Prostate Enlargement Treatment at our Specialised Prostate Clinic, ReSCUE Urology Hospital in Bangalore, Kengeri
Radical prostatectomy is an operation to remove the prostate gland and tissues surrounding it. This usually includes the seminal vesicles and some nearby lymph nodes. Radical prostatectomy can cure prostate cancer in men whose cancer is limited to the prostate. The prostate gland lies just under the bladder, in front of the rectum.
Surgeons choose from two different approaches to reach and remove the prostate during a radical prostatectomy.
Open prostatectomy- This is a traditional method in which the surgeon makes an vertical incision about 8-10-inch below the belly button. In rare cases , the incision is made in the space between the scrotum and the anus.
Laparoscopic prostatectomy- In this method the surgeon makes several small incisions across the belly. Surgical tools and a camera are inserted through the incisions, and a radical prostatectomy is performed from outside the body.The surgeon views the entire operation on a screen.
Robotic prostatectomy- Small incisions are made in the belly. A surgeon controls an advanced robotic system of surgical tools from outside the body. A high tech interface lets the surgeon use the movements and a 3-D screen during radical prostatectomy.
Doctors first try to establish that the prostate cancer has not spread beyond the prostate.
The above is determined by comparing the results of the biopsy and PSA results.
Further testing may include CT scan, bone scans, MRI scans and ultrasound.
If cancer has not spread the surgeon might offer other options besides surgery.
The other options could include radiation therapy, hormone therapy, or simple observation giving antibiotics.
Hospice care and probable stay duration
● You will probably stay in the hospital for a few days after the surgery.
● The catheter will stay in place 1 or 2 weeks while you heal.
● You will be able to urinate on your own after the catheter is removed.
● You need to bring an overnight bag for the necessary x-rays and medications you take regularly.
● Please ensure you bring all the paperwork provided to you by the concerned doctor.
● Fasting is necessary for about 6 hours prior to the surgery since general anaesthesia or spinal anaesthesia is given.
● If you are a diabetic please inform the doctor.
● Bowels are to be cleared by you naturally or a microlax enema is given.
● Medications: your prescribed medications can be taken during the surgery except for blood thinners which need to be stopped.
● A blood test should be performed on the morning of the surgery to ensure that the blood is clotting appropriately.
● Anticoagulant medications should be ceased 5 days prior to the surgical procedure and not to be resumed until one to two weeks after the surgery.
● All natural therapy preparations must be stopped as they may interfere with the clotting ability of the blood.
● Please ensure the doctor in charge of the TURP surgery is aware of all the drugs, pills and medications you take whether you have a prescription or not.
Anaesthesia and Surgery
● In the operation theatre, the anaesthetist will take a medical history from you.
● He then decides whether you would be under general anaesthesia or spinal anaesthesia.
● In spinal anaesthesia, a needle is pricked on your spinal cord to avail numbness from waist down.
● In the case of general anaesthesia, you may be made to sleep for the duration of the operation.
● A combined visual and surgical instrument ( resectoscope ) is inserted through the tip of the penis and into the tube that carries urine from the bladder ( urethra ). The prostate surrounds the urethra, the doctor now trims the excess prostate tissue that is blocking urine flow.
● You will be taken to the recovery room after surgery.
● Hospital staff will monitor your heart rate, breathing, oxygen levels and other vitals.
● The doctor will monitor closely for post-TURP syndrome which includes dizziness, headache, slow heartbeat, shortness of breath, seizures and even coma.
● A catheter is placed through your penis into your bladder until your prostate heels.
● Removal of extra prostate tissue should help you to urinate more easily and less frequently.
● Most men who have this surgery are back to their regular activities in 6 to 8 days.
Risks and complications
Tips for better recovery
● Stay hydrated with 8 to 10 glasses of water each day.
● Eating a healthy balanced diet.
● Avoid sexual intercourse for 1 or 2 months.
● Avoid lifting heavy items for 1 or 2 months.
● Limiting exercises that put a strain on the groin or lower abdominal area.
● Avoid stimulants such as caffeine, alcohol and nicotine.
● Limiting the use of over the counter drugs that can cause dehydration such as decongestants and antihistamines.
When to see a doctor
● Bleeding from urethra, outer prostate or penis.
● Inflammation and pain in the urethra, prostate or penis lasting longer than 2 weeks and worsening.
● Reduced urine flow or urine incontinence or urine urgency 6 weeks post surgery.
● Blood in urine even after 4 to 6 weeks after surgery.
● Severe clots of blood in urine or urine that is entirely red.
● Weakness or fatigue persists 4 weeks after surgery.
● Impotence or erectile dysfunction.
● Dizziness, shortness of breath.
● Severe or intensifying abdominal pain or discomfort.
This is the swelling of the small of the small walnut-sized gland known as prostate and it produces seminal liquid. This is a very common situation present in more than 1 million cases per year.
Learn about the investigations and the diagnosis
● Antibiotics: This is the most commonly prescribed treatment for prostatitis. The doctor will choose the medication for you based on the bacteria that might have caused the infection. When infection is severe intravenous(IV) antibiotics would be given. This treatment may go on for 4 to 6 weeks.
● Alpha blockers: These medications help in relaxing the bladder neck and muscle fibres where your prostate joins the bladder. This will ease pain during urination.
● Anti-inflammatory agents: Nonsteroidal anti-inflammatory drugs might help you feel better.
Ricks and Complications
● Recurrence of bacterial prostatitis if not cured fully.
● Being young or middle-aged and having infection in the bladder or tube that transports semen and urine to the penis.
● Having pelvic trauma, such as an injury from bicycling or horseback riding.
● Bacterial infection of the blood.
● Inflammation of the coiled tube attached to the back of the testicle.
● Pus-filled cavity in the prostate.
● Semen abnormalities and infertility which can occur with chronic prostatitis.