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Prostate and BPH

- By Dr Vikas Singh,
M.B.B.S., M.S., M.Ch.
Urologist, Genito Uro Oncologist and Kidney Transplant Surgeon,
Kokilaben Dhirubhai Ambani Hospital, Indore.

The prostate is a small gland in the male reproductive system that produces seminal fluid, a component of semen. It is located below the bladder and surrounds the urethra, the tube that carries urine and semen out of the body. The prostate is an important organ as it helps to nourish and transport sperm, and is essential for male fertility. It can also be prone to a variety of problems, including benign prostatic hyperplasia (BPH) and prostate cancer, both of which can impact urinary and sexual function. Regular screening and early detection of prostate problems are important for maintaining good prostate health.


Prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition that affects many men as they age. .

Here are some frequently asked questions about BPH:

What are the symptoms of BPH?

The most common symptoms of BPH include:

  • Frequent urination

  • Urgency to urinate

  • Difficulty starting urination

  • Weak urine stream

  • Dribbling at the end of urination

  • Incomplete emptying of the bladder

  • Nocturia (waking up at night to urinate)


Who is at risk for developing BPH?

BPH is a common condition that affects men over the age of 50. The risk of developing BPH increases with age, and it is estimated that up to 90% of men over the age of 80 have some degree of prostate enlargement.


How is BPH diagnosed?

BPH is usually diagnosed by a urologist or primary care physician based on a patient's symptoms, medical history, and physical exam. The physician may also order diagnostic tests such as a prostate-specific antigen (PSA) blood test, urine flow test, or ultrasound to confirm the diagnosis and rule out other conditions.


Can BPH be prevented?

There is no guaranteed way to prevent BPH, but there are some lifestyle changes that may reduce the risk of developing the condition. These include maintaining a healthy weight, exercising regularly, avoiding alcohol and caffeine, and avoiding medications that may worsen urinary symptoms.


How is BPH treated?

Treatment for BPH depends on the severity of symptoms and the patient's overall health. Mild to moderate symptoms may be managed with lifestyle changes and medications such as alpha-blockers or 5-alpha-reductase inhibitors. In more severe cases, surgery may be necessary to remove part or all of the prostate gland.

There are several surgical options available for the treatment of BPH, including endoscopic surgical procedures. The following are the most commonly used endoscopic surgical operations for prostate enlargement:

  1. Transurethral Resection of the Prostate (TURP): TURP is the most common and well-established endoscopic procedure for the treatment of BPH. In this procedure, a resectoscope is inserted into the urethra to remove the enlarged prostate tissue. The procedure is performed under general or spinal anesthesia, and patients can expect to go home the same day or the next day.

  2. Transurethral Vaporization of the Prostate (TUVP): TUVP is a minimally invasive alternative to TURP. In this procedure, high-frequency energy is used to vaporize the enlarged prostate tissue. The procedure is performed through the urethra and requires only local anesthesia.

  3. Transurethral Electrovaporization of the Prostate (TUEVP): TUEVP is similar to TUVP, but instead of using high-frequency energy, a low-frequency current is used to vaporize the enlarged prostate tissue. This procedure is also performed through the urethra and requires only local anesthesia.

  4. Holmium Laser /TFL Enucleation of the Prostate (HoLEP/ThuFLEP): HoLEP is a newer procedure that uses a holmium laser to remove the enlarged prostate tissue. The procedure is performed through the urethra and requires only general anesthesia.

  5. Photoselective Vaporization of the Prostate (PVP): PVP is a minimally invasive procedure that uses a laser to vaporize the enlarged prostate tissue. The procedure is performed through the urethra and requires only local anesthesia.

These endoscopic surgical procedures are safe and effective for the treatment of BPH. However, each procedure has its own advantages and disadvantages, and the best choice for each patient will depend on their individual medical history, anatomy, and symptoms. It is important to discuss the options with your doctor and choose the procedure that is best for you

What are the potential complications of BPH?

If left untreated, BPH can lead to complications such as urinary tract infections, bladder stones, and kidney damage. It is important to seek treatment for BPH to prevent these complications from occurring.


What can I do to manage my symptoms of BPH?

There are several things you can do to manage your symptoms of BPH, including:

  • Urinate when you first feel the urge, rather than holding it in

  • Try double voiding (urinating, waiting a few minutes, and then urinating again)

  • Limit fluid intake before bedtime to reduce nocturia

  • Avoid alcohol and caffeine, which can irritate the bladder

  • Exercise regularly to improve overall health and reduce stress


What can I expect during a prostate exam?

During a prostate exam, your physician will insert a gloved, lubricated finger into your rectum to feel the prostate gland for size, shape, and texture. The exam is usually quick and painless, but some men may experience discomfort or embarrassment.


Are there any alternative therapies that may help with BPH symptoms?

Some men find that certain alternative therapies, such as saw palmetto, pygeum, or rye grass pollen extract, may help with BPH symptoms. However, there is limited scientific evidence to support the effectiveness of these treatments, and they may interact with other medications. It is important to speak with your physician before trying any alternative therapies.

Increase in Prostate size or its infection causes severe urinary symptoms. Medications and if necessary LASER prostate procedure is used for treatment.
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