Prostate: Benign Enlargement

Benign prostate enlargement (BPE) is the medical term to describe an enlarged prostate, a condition common to men over 50 years old which can affect urination. It is not usually a serious health threat, but it needs to be treated in certain circumstances such as when the patient is bothered by his symptoms, has an abnormal kidney function test, is experiencing recurrent urinary tract infections or has developed bladder stones.

Abdali Hospitals’ urology team is highly experienced in the diagnosis and treatment of prostate conditions, supported by the latest techniques, including laser (Holep) and the Rezum device.

Diagnosis

The following tests are common to diagnose a prostate condition:

• Digital rectal exam to check your prostate for enlargement
• Urine test to assess infections or other conditions
• Blood test to assess kidney problems
• Prostate-specific antigen (PSA) blood test to assess an enlarged prostate and rule out any other underlying pathology.

Other tests may include

• Urinary flow test that measures the strength and amount of your urine flow
• Postvoid residual volume test.This test measures whether you can empty your bladder completely
• 24-hour voiding diary.Recording the frequency and amount of urine.

If your condition is more complex, your doctor may recommend

• Transrectal ultrasound to measure and evaluate your prostate.
• Prostate biopsy to take tissue samples (biopsies) of the prostate in case of cancer suspicion
• Urodynamic and pressure flow studiesto measure bladder pressure how the bladder muscles work
• Cystoscopy to see inside your urethra and bladder (especially if you have blood in your urine)

Treatment

Different treatment measures are possible, depending on your case. The most common are:

• Medication: these may include alpha blockers, that relax bladder neck muscles and muscle fibers in the prostate; 5-alpha reductase inhibitors, that shrink your prostate by preventing hormonal changes that cause prostate growth; or a combination of both
• Transurethral resection of the prostate (TURP) A light assisted scope is inserted into your urethra, and the surgeon removes all but the outer part of the prostate. We perform both Monopolar transurethral resection of prostate (M-TURP) and bipolar B-TURP
• Transurethral incision of the prostate (TUIP) A lighted scope is inserted into your urethra, and the surgeon makes one or two small cuts in the prostate gland/bladder neck - making it easier for urine to pass through the urethra
• Laser therapy using our latest equipment Holmium laser enucleation of the prostate (HoLEP), that removes all the prostate tissue blocking urine flow and prevent regrowth of tissue. This technique is particularly useful for large prostates (over 80 grams)
• Rezum Powered by convective water vapor energy, delivers targeted, controlled doses of the stored thermal energy in water vapor directly to the region of the prostate gland with the obstructive tissue, this technique is useful for small to medium sized prostates (up to 80 grams)
• Minimally invasive surgery, prostatectomy, may be necessary when other techniques cannot be applied. These include retropubic, perineal, and laparoscopic surgeries. When surgery is necessary, our surgeons are extremely experienced, achieving excellent outcomes.