Overview

Benign prostatic hyperplasia (BPH) — also called prostate gland enlargement — is a common condition as men get older. An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder. It can also cause bladder, urinary tract or kidney problems.

There are several effective treatments for prostate gland enlargement, including medications, minimally invasive therapies and surgery. To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have and your preferences.

Symptoms

The severity of symptoms in people who have prostate gland enlargement varies, but symptoms tend to gradually worsen over time. Common signs and symptoms of BPH include:

• Frequent or urgent need to urinate

• Increased frequency of urination at night (nocturia)

• Difficulty starting urination

• Weak urine stream or a stream that stops and starts

• Dribbling at the end of urination

• Inability to completely empty the bladder

Less common signs and symptoms include:

• Urinary tract infection

• Inability to urinate

• Blood in the urine

The size of your prostate doesn't necessarily determine the severity of your symptoms. Some men with only slightly enlarged prostates can have significant symptoms, while other men with very enlarged prostates can have only minor urinary symptoms.

In some men, symptoms eventually stabilize and might even improve over time.

Other possible causes of urinary symptoms

Conditions that can lead to symptoms similar to those caused by enlarged prostate include:

• Urinary tract infection

• Inflammation of the prostate (prostatitis)

• Narrowing of the urethra (urethral stricture)

• Scarring in the bladder neck as a result of previous surgery

• Bladder or kidney stones

• Problems with nerves that control the bladder

• Cancer of the prostate or bladder

When to see a doctor

If you're having urinary problems, discuss them with your doctor. Even if you don't find urinary symptoms bothersome, it's important to identify or rule out any underlying causes. Untreated, urinary problems might lead to obstruction of the urinary tract.

If you're unable to pass any urine, seek immediate medical attention.

What to expect post URSL surgery?

Here’s what you can expect after URSL surgery :

You will be shifted to a recovery room, and the doctors will monitor your condition. If the doctors do not suspect complications, you’ll be discharged on the same day.

It is normal to experience some pain and discomfort due to stent insertion. The doctor will prescribe medicines to help relieve the pain.

Some people might notice blood in their urine, which is also very normal and generally subsides within a week or two of the surgery.

Recovery after URSL surgery

The recovery period after URSL surgery is quite short and most patients can resume their routine within a week of the surgery, without experiencing any complications.Taking some precautions and making some changes in your lifestyle can help you recover even faster. Here are some tips that can help you recover quicker:

• Eat a healthy diet and drink plenty of fluids. Make sure that your diet is packed with fiber.

• Do not indulge in heavy workout for a couple of days after the surgery.

• Make sure you take the medicines prescribed by the doctor without fail. Skipping these medicines can delay the recovery process. Also, if you experience abnormal symptoms, get in touch with your doctor immediately.

Surgery Preparation

BPH doctors may recommend several tips before the enlarged prostate procedure to reduce the complications during the surgery. Here are some pre-surgery tips that can help you prepare for the prostate surgery –

• Inform your doctor regarding any ongoing medications before the surgery.

• Discuss your current medical condition (if any) with the concerned BPH doctor to reduce the risks during the procedure and how they can be avoided.

• Wearing loose-fitting clothes can help avoid discomfort around the surgical site.

• Stop smoking tobacco a week before the surgery.

• Inform your doctor if you have a history of allergies related to anesthesia.

• Do not eat or drink 8 to 9 hours prior to the surgery. Doctors generally recommend skipping dinner or refraining from eating anything after midnight.

Procedure

Surgical procedures for an enlarged prostate include TURP, TUIP, and HoLEP. TURP and TUIP are minimally invasive surgeries whereas HoLEP is a laser procedure. Here is how different procedures for an enlarged prostate are performed –

• Transurethral Incision of the Prostate (TUIP):

TUIP is a minimally invasive surgery done to treat urinary symptoms due to enlarged prostate. This procedure is common in younger men with small prostate who are concerned about fertility. Once the patient is given anesthesia, the surgeon inserts a resectoscope through the tip of the penis, inside the urethra (a thin tube that carries urine from your bladder). The surgeon combines visual and surgical instruments to observe and treat enlarged prostate with precision.

The surgeon begins by making a tiny incision in the area where the prostate and bladder are connected. This widens the urinary channel and allows the urine to pass through more easily. The surgeon may choose to leave the catheter in the bladder for a day or two after the surgery to drain the bladder. The patient generally experiences instant relief from the urinary symptoms and often has long-term benefits.

• Transurethral Resection of the Prostate (TURP):

TURP is also a minimally invasive procedure to treat enlarged prostate symptoms. The surgeon uses a resectoscope (containing light, camera & loop of wire) which is inserted into the urethra through the penis. The patient is given anesthesia before the procedure. This loop of wire is heated with an electric current and a tiny incision is made in your prostate to treat urinary symptoms. The doctor may choose to insert a catheter to flush out the excessive blood and pieces of tissues that are removed.

• Holmium Laser Enucleation of the Prostate (HoLEP):

HoLEP is a laser procedure to treat urinary symptoms caused due to an enlarged prostate. In this procedure, the urologist inserts a thin, tube-like instrument called a resectoscope. The surgeon uses an advanced Holmium laser to destroy the excess prostate tissue without the need for any incision. The patient is given anesthesia before the beginning of the procedure. The surgeon may choose to use a catheter which is usually removed the next day of the surgery.

What to expect after BPH surgery?

After your BPH surgery, you will be transferred to the recovery room where your vitals will be monitored. The doctor will examine your recovery process and prescribe you medications accordingly. Since you will be under the effects of anesthesia, you may feel dizzy after the procedure. You may experience a mild burning sensation during urination which should not last longer than 3 days.

In addition, you may also observe difficulty with the bowels after the surgery. You can ask your physician or doctor for some laxatives or stool softeners to reduce the discomfort. Recovery generally takes 7-10 days depending on the medical health of the patient, severity of the condition, and the surgical expertise of the BPH surgeon.

Benefits of enlarged prostate (BPH) treatment in India

Prostate laser surgery improves urine flow for most men right after the procedure. The results are often long term and patients may feel relieved of enlarged prostate symptoms. Modern surgical procedures for an enlarged prostate offer the following advantages –

• Minimal blood loss

• Minimal Pain

• No visible scars

• No major pain

• Faster recovery

• Fewer hospital stays

• Return to daily routine quickly

• Almost zero chances of complications

• Few chances of recurrences

Complications of untreated BPH

BPH often results in several urinary issues which can become a major health concern if not treated on time. Since BPH is more common in individuals above the age of 60 years, prolonging treatment causes chronic urinary issues which can also affect the surrounding organs. Untreated BPH can cause the following complications –

• Sudden inability to urinate

• Urinary tract infections

• Kidney stones

• Bladder damage

• Kidney damage

Recovery after BPH procedures

Recovery after BPH surgery usually takes around a week depending on the patient’s health, type of procedure, existing medical condition, etc. The patient is usually discharged within 2-3 days from the hospital if the doctor does not suspect any complications. Some of the post-operative care after your BPH surgery are-

• Do not lift heavy equipment for around a week after your surgical procedure.

• Restrict heavy exercises for about 6 weeks after BPH surgery.

• Drink plenty of fluid during the first 2 weeks after the surgery to flush any new bleeding from the bladder.

• Avoid alcohol and coffee for the first few weeks after the procedure.

• Avoid food that can cause constipation or force you to strain during bowel movements.