Benign prostate enlargement
What is benign prostate enlargement?
Unlike other organs in the body, the prostate gland continues to grow during
every man’s lifespan. The prostate grows gradually after the age of about
50 and by the age of 70, approximately 8 out of 10 men have an enlarged prostate.
What are the symptoms of an enlarged prostate?
Approximately 1 in 3 men will experience symptoms as a result of having an enlarged
prostate gland. Most commonly, these symptoms will be:
• A weak flow of urine
Urine flow is weak and it takes longer to empty the bladder.
• Hesitancy
Having to wait at the toilet before the urine starts to flow.
• Problems emptying
Feeling your bladder is not empty after you have been to the toilet.
• Frequency
Having to pass urine more often than before, often needing to get up several
times during the night.
What causes the symptoms?
The prostate gland grows like a doughnut around the urethra, the tube or ‘water
pipe’ through which urine flows. The effect of having an enlarged prostate
is like a kink developing in a water pipe – it blocks the normal flow
of water.
Not everyone with an enlarged prostate will develop symptoms; it depends how
the prostate presses upon the urethra and lower bladder. If left untreated,
an enlarged prostate resulting in urinary symptoms can lead to infections and
more rarely, kidney damage.
It is important to note that not all urinary symptoms in men are the
result of an enlarged prostate. If you have blood in your urine or experience
pain, it is important that you have a full assessment to check whether the problems
may be caused by other prostate, bladder or kidney problems.
How is the condition diagnosed?
A doctor may examine your prostate to feel how big it is. A special ultrasound
test provides an accurate prostate volume. You may need to have blood and urine
tests to check the function of your kidneys and rule out other potential problems,
such as infection.
Specialists at Birmingham Prostate Clinic sometimes use a cystoscopy, a special
telescope to examine the bladder.
You may be asked to have a urine flow test to assess the blockage and a scan
to look at the prostate and the bladder.
How is the condition treated?
Active monitoring
In some cases, it is best to monitor the patient and undertake regular assessments
of the symptoms and their impact on the patient’s lifestyle. Immediate
treatment may not be necessary; however it is important to assess the patient
on a regular basis.
Medication
Medication can be used to relax the muscle tissue around the bladder and in
most cases, there is some improvement within days, with full benefits evident
by six weeks. Patients may experience side-effects and different combinations
of medicines are often used to ensure the greatest benefit. It is therefore
critical that the medication is managed by a specialist in prostate disorders.
Surgery
The most common operation undertaken for benign prostate enlargement is called
a transurethral resection of the prostate or TURP. During this procedure the
surplus parts of the prostate are removed using a heated wire in order to reduce
the restriction around the urethra. Patients will spend an average of 3-4 days
in hospital followed by a recovery period at home. There are several complications
associated with surgery. Studies estimate around 74 per cent of men will experience
retrograde ejaculation, when sperm enters the bladder instead of being expelled
through the penis. Sexual dysfunction and urinary incontinence are complications
affecting a smaller proportion of men after surgery.
Green light laser therapy
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