Enlarged Prostate

Dr Christopher Love can help with treatment for Enlarged Prostate (Benign Prostatic Hyperplasia)

Enlarged Prostate

Benign Prostatic Hyperplasia (BPH)

In more than 50% of men over 50, the prostate gland enlarges which can cause a number of urinary symptoms. This is known as Benign Prostatic Hyperplasia (BPH). There are a number of treatments available to help relieve the symptoms, and Dr Love can help find the right one for you.

What is the prostate and what does it do?

What is the prostate and what does it do?

The prostate is a gland located in the male pelvis, underneath the bladder and surrounding the urethra (water-tube), as it comes out from the bladder. Behind the prostate and bladder are the seminal vesicles, two small sacks that attach to the prostate and produce material that mixes with the prostatic fluid to form semen. The tubes from the testicles (vasa) carry sperm to the prostate where the sperm are mixed with the prostate and the seminal vesicle fluid. The fluid is then ejaculated during orgasm by a connection to the urethra called the ejaculatory ducts.

What is Prostate Disease?

What is Prostate Disease?

Prostate disease is a term used to describe any medical problems involving the prostate gland. Common prostate problems experienced by men include: Prostatitis which is inflammation and swelling of the prostate gland; Benign prostatic hyperplasia (BPH), which is a non-cancerous (benign) enlargement of the prostate gland and occurs in virtually all men as they get older; Prostate cancer.

What is Benign Prostatic Hyperplasia (BPH)?

This is the normal, gradual and inevitable enlargement of the prostate, part of the ageing process in men, and it commonly leads to a variety of changes in the way the bladder works, and those changes are called lower urinary tract symptoms (LUTS).

BPH is one of the most common diseases affecting the prostate and is the most common benign tumour in men as they get older.

This condition is present in 50% of men over 50 years.

The prostate size can be assessed by a digital rectal examination where a gloved and lubricated finger is inserted into the anus, or by ultrasound. The size of the prostate is less important than the urinary symptoms it causes. This digital examination may also feel a cancerous lump, though not all prostate cancers can be felt in this manner.

LUTS (Lower Urinary Tract Symptoms)

Dr Love can test the severity of your symptoms with a urine flow tests, as well as measurements of retained urine, and by asking you specific questions about your symptoms. The International Prostate Symptom Score questionnaire is also a very useful tool.

The PSA blood test, ultrasound of kidneys and bladder and urine tests also give further valuable information.

What are LUTS?

Lower Urinary Tract Symptoms

LUTS (lower urinary tract symptoms) are the things the patient notices when their bladder is affected by an enlarging prostate. They can include the following:

  • Delay in getting urine flow started
  • Weaker or slower flow of urine
  • Dribbling at the finish of passing urine
  • Going more often
  • Getting up at night to pass urine
  • Needing to rush to get to the toilet (urgency)
  • Not emptying the bladder possibly leading to urinary infections or bladder stones
  • Loss of control of the bladder
  • Blood in the urine

The International Prostate Symptom Score questionnaire is a useful way of assessing the severity of your symptoms.

What are the treatments for BPH?

Treatments range from watchful waiting (observation only), various medications, through to different types of surgery. If the patient’s symptoms (LUTS) are not too severe or annoying, and as long as prostate cancer or other problems are ruled out, the decision may be made to only keep the enlarged prostate under observation and not offer any initial treatment. However if the patient is bothered by the symptoms, or other issues are developing such as a large amount of retained urine, Dr Love would recommend treatment.

Dr Love has extensive experience in all forms of treating Benign Prostatic Hyperplasia (BPH).

Dr Love has extensive experience in all forms of treating BPH, and is an active user of TURP, GreenLight®, and, particularly, the MIST therapies, steam ablation of the prostate and prostatic lift technique.

Treatments could include:

  • Prescription medications are able to reduce the symptoms of prostatic obstruction.
  • Medications derived from plants that have been shown to have some benefit e.g. Saw Palmetto. Often, these provide only temporary relief and eventually surgery is required.
  • There have been a number of  “minimally-invasive” surgical treatments (MIST) for BPH over the years, and Dr. Love has had experience with all of them. Many have proved unsatisfactory in the medium to long term, and the only ones that have been shown to be really useful for patients are the Steam ablation of the prostate technique and the prostatic lift technique, which are achieving good results with follow-up beyond 5 years, done as day case procedures, with no side-effects, particularly no sexual side-effects.
  • More traditional, and somewhat “old-fashioned” surgical treatments for BPH are still very useful in some cases. Transurethral surgery of the prostate (TURP) is actually also a reasonably minimally invasive way of treating prostatic obstruction and has been the “gold standard” treatment for many years, giving excellent results usually requiring just a two-day visit to the hospital.
  • However, laser surgery, especially GreenLight® laser, has proved to be an alternative to TURP, because there is virtually no bleeding and sometimes men are in hospital for as little as 12 – 18 hours after this form of prostate surgery.
  • There can be some sexual and other side-effects from both TURP and GreenLight®.
  • Some patients are more suitable for one, rather than one of the other, treatments, and must be assessed individually. Make an appointment with Dr Love to discuss which BPH therapy is right for you.

Dr Love discusses treatment options for Enlarged Prostate

From the Podcast

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