Benign prostate enlargement: Symptoms and Treatment

In this video, Dr. VijayPal Singh Consultant Urologist Chandigarh talks about the condition of benign prostate enlargement. It is called prostatomegaly, or an increase in prostate size. 

What is benign prostate enlargement?

The prostate is mainly present in the male sex. Typically it’s a 20 gm walnut-size gland. Basically, it encircles around the urethra behind the urinary tract. Besides, this gland can cause many diseases like benign prostate enlargement and prostate cancer. Above all, it can cause prostate inflammation and prostate infection. 

What are the common symptoms of benign prostate enlargement?

Besides, it affects after the 50 years of age group. Basically, the prostate gland’s size increases after 50-70 years of age, narrowing the urinary passage. The patient develops symptoms. We can divide symptoms into two subgroups: voiding  and storage symptoms.

Indication of storage symptoms

Storage symptoms occur due to changes in the urinary bladder. Voiding symptoms include hesitancy in initiating urination and poor flow of urine. Evidently, patients may need to push themselves to pass urine. Altogether, the urinary bladder doesn’t get empty. There is always some residual urine left in the urinary bladder. Altogether, the storage symptoms bother the patients more. They are pretty irritating, like frequent urination and urgency.

Complications of prostatomegaly

Some complications of benign prostate include recurrent urinary tract infections and hematuria. As a matter of fact, there are bladder stones due to urine blockage.

Diagnosis

The clinical examination of the patient is critical to diagnose the condition. The most important in this is distal rectal examination. First, doctors assess the prostate’s approximate size. Altogether, doctors check for the presence of any nodules or suspicious malignancy and rectal tone. Then comes the urine examination and culture.

Imaging techniques for diagnosis

Ultrasound of the urinary bladder determines the residual urine. It explains how much residual urine is present in the urinary bladder. In addition, doctors examine the prostate size and changes in the urinary bladder. Depending on the patient’s condition, one can also opt for uroflowmetry and cystoscopy.

Who needs a PSA test?

Sometimes doctors recommend PSA tests for prostate cancer screening. 

Treatment

General category

The planning of the therapy is majorly on the patient’s symptoms and the complicating factors. In most cases, doctors suggest behavioural therapies and management. Additionally, doctors recommend pelvic floor exercises.

Moderate category

For bothersome symptoms, doctors give medical management. It includes alpha-blockers, bladder relaxants, and anticholinergics. 

Surgical treatment 

Doctors suggest surgery when medical management fails, or the patient cannot tolerate the medicines. In addition, complications like recurrent UTI, recurrent haematuria (blood in urine), or formation of stones require surgery. Altogether, an increase in prostate size and changes in the bladder require surgical treatment. There are lasers,HoLEP and HoLAP. 

What is TURP?

The gold standard of treatment is TURP. There are minimally invasive surgical therapies (MIST),UroLift, and bladder neck incision or bladder neck resection. However, it is opted only after analysing the patient’s condition, complicating factors. Sometimes it also depends upon the comorbidity and gland size.