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Rising Kashmir > Blog > Opinion > Prostate Enlargement: Symptoms and Treatment
Opinion

Prostate Enlargement: Symptoms and Treatment

Prostate enlargement issues are common in men especially > 50 yrs. of age and 50 % patients would develop some prostatic symptoms

DR. H. S. BHATYAL
Last updated: April 13, 2024 5:54 am
DR. H. S. BHATYAL
Published: April 13, 2024
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Prostate is a small walnut shaped gland in men that sits just below the bladder and surrounds the urethra (tube carrying urine outside the bladder). Prostate has various functions -seminal fluid secretion (component of semen), hormone production and regulates flow of urine. Prostate enlargement issues are common in men especially > 50 yrs. of age and 50 % patients would develop some prostatic symptoms.

 

Symptoms could be bothersome, disrupting quality of life.

 

Symptoms

  • Obstructive symptoms – Hesitancy, thinning of urine stream, intermittency, incomplete emptying of bladder, overflow incontinence (passing urine without knowledge).
  • Irritative symptoms – Increased frequency, urgency (difficult to control urine), involuntary passing of urine, pain during passing urine.
  • Haematuria – Blood in urine (rarely).
  • Severity of symptoms may vary from person to person, some may carry on, others may find it difficult as it impacts daily activity & sleep.

 

Diagnosis

  • Physical Examination – Digital rectal examination: USG of kidney, ureter and bladder area is mandatory to check the size of prostate, abnormal texture, bladder volume, residual urine after passing urine and state of kidneys.
  • Blood Test – PSA: Marker of prostate cancer.

 

Neglecting the symptoms may lead to large volume of urine in the bladder-resulting in recurrent UTI, bladder stones formation and deterioration of kidney function.

 

Treatment

Treatment primarily depends on type of symptoms:

 

Lifestyle changes – Limit tea coffee, alcohol intake, and decreased fluid intake in evening.

 

Medical management – For medical management following medications are prescribed to settle the condition

 

Relaxation of prostatic muscles and bladder neck- Alpha blockers-Alfuzosin, Tamsulosin & Silodosin

 

Decrease the size of prostate – Finasteride, Dutasteride (this is given in elder patients with large prostates)

 

Irritative symptom treatment – Solifenacin, Darifenacin, Mirabegron

 

Minimally invasive treatments – Laser Vaporisation of prostate, TURP, Bipolar TURP, HOLEP (Holmium laser).

 

Urolift, Rezum Therapy – (modalities need to be established).

 

Robotic simple prostatectomy –The surgery is done for very large sized prostates.

 

Open prostatectomy-This procedure is very rarely done now a days.

 

 

(Author is Senior Director & HOD – Urology & Renal Transplantation, BLK-Max Super Specialty Hospital, New Delhi)

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