Description

Prostate Enlargement

Benign
Prostate Growth: Prostate is a small gland located under the bladder in men. It
is an organ the size of a chestnut and surrounds the lower urinary tract called
the urethra. Although the prostate is found throughout the life of men, it
usually begins to grow after middle age. As men age, the prostate
continues to grow and can compress the urinary tract. The larger than
normal prostate gland is hypertrophic, this condition is called “Benign
Prostate Growth” (BPH). An enlarged prostate does not mean cancer. With
aging, enlargement of the prostate is inevitable, but urinary complaints of
prostate enlargement may not always be present.

 

Symptoms
of BPH

Poor
urine flow

Delay
in starting urine

Making
urine cuts

The
feeling that the bladder is not fully emptied

Frequent
urination during the day

Frequent
urinary tract infections

Sudden
urgency and sometimes urinary incontinence

Do
not urinate at night 

Diagnosis
of BPH

Evaluation
of BPH begins with a physical examination, including a digital rectal
examination. A digital examination helps the doctor to have a poor
understanding of the size and consistency of the prostate. The tests used
in the diagnosis of BPH are the simple urine test and the PSA test taken from
the blood. Other tests that are helpful are uroflowmetry and PVR
examination. Uroflowmetry measures the rate of urine flow and the amount
of urine produced. PVR is the determination of the amount of urine
remaining in the bladder after voiding and is usually checked with the help of
ultrasound. Sometimes pressure-flow tests may be required to determine the
cause of urinary complaints. This test is performed in an outpatient
hospital and provides more detailed information about the bladder and urine
flow. Prostate ultrasound can also be performed in terms of determining
the exact size of the prostate and examining the areas suspicious for
cancer. 

Treatment of BPH 

Follow-up
without treatment is a good choice for patients who do not have obvious
complaints and want to wait until their symptoms become evident. Before
this decision, a urologist should be examined and tested.

Medical treatment

Finasteride
is an oral drug that is sometimes used to shrink the prostate and reduce
urinary complaints. Sometimes it may take a few months to notice
improvement in urinary complaints, and if treatment is discontinued, the
complaints may return. Erection problems and decreased sexual desire can
be seen as a side effect of Finasteride.

Alpha blockers  

These
drugs relax the smooth muscles of the prostate, thereby reducing urinary
complaints. It may take several weeks for improvement to be noticed. Potential
side effects of alpha blockers are headache, weakness, and low blood pressure. As
long as drugs are used, alpha blockers effectively reduce urinary complaints
and cannot reduce prostate size.

Herbal remedies

They
can provide a slight improvement in patients with mild complaints. The
most commonly used are Saw Palmetto and Seronea ripens.

Surgical TURP  

Transurethral
prostate resection, that is, closed surgery, is a surgery frequently performed
in BPH. The instrument used in TURP surgery is inserted into the urinary
tract and advanced until the prostate obstructs the urinary tract. Enlarged
tissues are removed by cutting with electricity. There is no incision
outside the body, and the hospital stay is usually a few days. After TURP
surgery, which has been used for many years, it is seen that the complaints
that have lasted for years in most patients quickly disappear.

Laser surgery

Laser surgery in BPH
is similar to TURP surgery. The prostate is reached through the urinary
tract, so there is no incision outside the body. Advantages of using
lasers include no bleeding, less hospital stay, and catheter time. In
recent years, the most modern method in the surgical treatment of BPH is
Holmium laser prostatectomy (HOLEP). With this method, all sizes of
prostate can be operated closed. 

Open prostatectomy

It
is applicable in the treatment of BPH patients with very large (over 90-100g)
prostates. In this type of surgery, an incision is made under the abdomen
and the enlarged prostate is removed. The disadvantages are the risk of
bleeding, long hospital stay and catheter time. Complications of BPH BPH
can cause serious complications if left untreated and monitored. The
presence of an enlarged prostate prevents the bladder from emptying. This
causes a resistance to build up during the flow of urine from the bladder,
causing a high pressure in the bladder. Increased pressure in the bladder
causes urine to escape back to the urinary tract and kidneys, which can cause
kidney failure. Higher than normal pressure in the bladder may also cause
the walls of the bladder made of smooth muscle to weaken by stretching it. Finally, Weakness
in the bladder muscle causes residual urine in the bladder even after
urination. The presence of residual urine in the bladder can also cause
frequent urinary tract infections that can reach the kidneys.