It is believed that all men are well aware that the prostate gland is part of the male reproductive organs responsible for producing seminal fluid. It is similar in shape to a chestnut or a nut that surrounds the urethra. Benign Prostatic Hyperplasia (BPH) is a condition where the prostate gland is abnormally enlarged, commonly found in men. This condition is age-related and is frequently seen in men aged around 50 and above.
Discovering the world close to you about enlarged prostate
Before we get to know more about enlarged prostate, let’s first understand clearly that enlarged prostate is a different disease from prostate cancer. An abnormally enlarged prostate can affect the urinary system in various ways, such as frequent urination, prolonged straining during urination, weak urine stream, nighttime urination, and inability to hold urine.
Did you know? As age increases, the chance and severity of symptoms also increase. The exact cause of the disease is still unknown, but it is speculated to be related to male hormones. Therefore, there is no prevention method yet. What every man can do to take care of himself from enlarged prostate is to observe any abnormalities, be vigilant, and get checked before the disease develops. So, let’s learn about enlarged prostate together.
Have you ever had these symptoms?
Symptoms caused by enlarged prostate affect the patient’s daily life and quality of life. Therefore, treatment aims to reduce the size of the prostate, alleviate urinary symptoms, and prevent complications such as kidney failure, urinary tract infections, and bladder stones.
Various treatment options
Each person is different, so treatment for enlarged prostate varies depending on symptoms. For example, patients with frequent nighttime urination may be treated without medication by lifestyle modification. However, patients who cannot urinate and require catheterization despite medication may need prostate surgery via endoscopy to enable urination. Before treatment, patients and doctors must set treatment goals together.
When it’s time to treat enlarged prostate
Treatment of enlarged prostate must be individualized and can be done in three ways: watchful waiting and lifestyle modification, medication, and surgery.
- Watchful waiting and lifestyle modification (Watchful waiting) is for patients with mild symptoms and no impact on daily life. Severity is assessed through history taking, physical examination, uroflowmetry to measure urine flow, and the International Prostatic Symptom Score (IPSS). Generally, if the questionnaire score is 7 or less, symptoms are mild and can be managed this way, with regular follow-ups. About 85% of patients maintain stable symptoms for 1 year, and 65% for 5 years. If symptoms worsen or urination becomes more difficult, the doctor will adjust treatment accordingly.
- How to modify lifestyle? First, avoid drinking water, tea, coffee, or alcoholic beverages before bedtime as they cause nighttime urination. Avoid certain blood pressure medications before bed as some have diuretic effects. For those with urgent urination and fear of leakage, schedule bathroom visits every 2-3 hours without waiting for the urge. Another important factor is preventing and treating constipation, which can cause frequent urination.
- Medication therapy (Medical therapy) is another treatment option used for more severe symptoms (IPSS > 7) or when urinary symptoms affect daily life. Common medications include smooth muscle relaxants of the prostate, which relax smooth muscles, widen the urethra, improve urine flow, and reduce straining. But if you ask whether there are side effects, the answer is yes. Such as dizziness, lightheadedness, fatigue, and nasal congestion. Another widely used medication is prostate size reducers, which gradually reduce prostate size by about 20% over 6-12 months, improving urination. These are often combined with smooth muscle relaxants for patients with prostate size over 30-40 grams. Side effects may include decreased sexual desire and performance. Regarding herbal medicines sold in stores, the doctor can only say that there is currently insufficient research to support or oppose their use.
Surgical therapy
This method is chosen when the above treatments fail. Surgery can be done in three ways: Transurethral resection of the prostate (TURP), or clearly explained as endoscopic prostate scraping through the urethra. This surgery has been popular for a long time with long-term patient follow-up and modern surgical equipment, making it an effective treatment. Suitable candidates include those unresponsive to medication, those who still cannot urinate and require catheterization despite medication, and those with complications from enlarged prostate such as recurrent urinary tract infections, blood in urine from enlarged prostate, decreased kidney function due to prostate enlargement, or bladder stones caused by enlarged prostate.
Innovations in enlarged prostate treatment
“Many patients want to know roughly what the surgery will be like. For enlarged prostate surgery, patients receive spinal anesthesia or general anesthesia, and the doctor performs endoscopic surgery through the urethra using instruments to scrape the prostate tissue, which is then sent for prostate cancer examination.”
As for laser surgery (Transurethral laser vaporization of prostate), it vaporizes the prostate tissue blocking the urinary tract. This method is effective, has fewer side effects, less bleeding during surgery, is safe, causes less injury, and requires a short hospital stay of only 1-2 days. It is suitable for patients with multiple underlying diseases and those at risk for endoscopic prostate surgery. The last method is open prostatectomy, an option for severely enlarged prostate requiring open abdominal surgery to remove excess tissue. Patients need to stay in the hospital for about 7-10 days.
Enlarged prostate is a common condition for all men. Therefore, I urge men to pay attention and observe any abnormalities regularly. Even if there are no symptoms, men over 40 should have annual prostate check-ups. One of the key principles of health care to remember is “Don’t be embarrassed to get checked and treated” for your own good health.
Phyathai 3 Hospital
