By Dr. Vikas Agarwal, Urology
The prostate gland which is about the size of a walnut can continue to grow throughout your life. However, after the age of 50, the prostate can become enlarged and block the urethra which results in problems in urination. This is known as Benign Prostatic Hyperplasia and can lead to further problems such as urinary tract infections and kidney problems and others.
Symptoms of an enlarged prostate:
- A weak or slow urinary stream
- A feeling of incomplete bladder emptying
- Difficulty starting urination
- Frequent urination
- Urgency to urinate
- Getting up frequently at night to urinate
- A urinary stream that starts and stops
- Straining to urinate
- Continued dribbling of urine
- Returning to urinate again minutes after finishing
Enlarged Prostate: Uroflowmetry Test
The uroflowmetry test measures the rate of urine flow during urination. This test is sometimes used to evaluate the impact benign prostatic hyperplasia (BPH) has on urine flow or to monitor the effect of treatment. A urine flow rate that is normal or nearly normal in a man with BPH may indicate that the bladder has become stronger to compensate for the partially blocked urine flow. A uroflowmetry test is called a pressure flow study when used with a pressure-recording catheter in the bladder. Pressure studies may help distinguish between urinary symptoms caused by blockage and those caused by a problem affecting the bladder muscles or nerves.
Some Treatment options for Benign Prostatic Hyperplasia:
- Primary medication of alpha-blockers – These are commonly prescribed when the prostate is mildly enlarged. This medication helps relax the muscles so that prostate gland relaxes and allows for proper urination to happen.
- Prostate size control with 5-alpha-reductase inhibitors – These medications control hormones which may affect the growth of the prostate. It also works to reduce the size of the prostate by reducing the hormones to an extent where the prostate may shrink in size and relieve symptoms of benign prostatic hyperplasia.
- Combination of the inhibitors and blockers – In such scenarios, the doctor may prescribe a combination of the two medications mentioned above to both relax the muscles and shrink the size of the prostate to reduce symptoms and problems occurring due to prostate enlargement.
- Minimally invasive surgical procedures – There are multiple types of minimally invasive surgical procedures where healing is quicker and relieves the symptoms quickly. Some of these procedures are:
- TURP or Transurethral Resection of the Prostate: Partial removal of the prostate with the help of a lighted scope inserted into the urethra.
- TUIP or Transurethral Incision of the Prostate: Surgical widening of the prostate to relieve pressure on the urethra without removal.
- TUMT or Transurethral Microwave Thermotherapy: This is where the enlarged prostate is destroyed and removed with the help of microwave radiation.
- Prostatectomy - This is the complete or partial removal of the prostate with an extensive surgery via conventional means and only done in specific cases where other options aren’t viable.