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BPH - Benign Prostatic Hyperplasia (Enlarged Prostate)

Benign prostatic hyperplasia (BPH), which is also known as prostate gland enlargement, blocks the normal urine flow in aged men. This condition can cause problems of the urinary tract system including kidneys and bladder.

Common signs and symptoms of BPH include:

  • Frequent urination, especially during night times

  • Feeling like the bladder is full despite emptying

  • Unable to initiate urination

  • A urine stream that stops and starts

  • Unable to empty the bladder

Enlarged prostate or BPH can be diagnosed by self or family history of BPH, a thorough physical examination and blood investigations. Mild BPH can be cured on its own without any treatment. Treatment options for moderate and severe BPH include:

  • Active surveillance: BPH can be treated by regular monitoring by a urologist. Symptoms can be managed with changes in the lifestyle including diet and regular exercise. 

  • Medications: Prescription drugs are given to unblock the urethra, improve the flow of urine, shrink the prostate gland to normal size and lower the complications of an enlarged prostate.

  • Minimally invasive procedure: When medications fail to improve the symptoms of BPH, minimally invasive surgery is recommended as it requires tiny cuts, no hospitalization, and is an out-patient procedure. These surgeries are of several types, including:

    • Prostatic Urethral Lift (PUL): Small implants with the help of a needle are placed in the prostate to compress the enlarged prostate and allow the free flow of urine.

    • Water Vapour Thermal Therapy: A known dose of steam is injected into the prostate to destroy the cells and shrink the gland. 

    • Transurethral Microwave Therapy (TUMT): Microwaves are injected into the prostate through a catheter to shrink the gland.

    • Catheterization: This procedure uses a catheter to drain the urine from the bladder.

  • More invasive surgery: 

    • TransUrethral Incision of the Prostate (TUIP): This procedure widens the urethra and makes urination easier.

    • Photoselective Vaporization (PVP): This procedure uses a cystoscope and laser beams to shrink the prostate gland. 

    • Transurethral Resection of the Prostate (TURP): This procedure uses a resectoscope that is inserted into the urethra via the penis. Electric current is used to destroy the obstructing prostate tissue. 

    • Holmium Laser Enucleation of the Prostate (HoLEP): This procedure uses a resectoscope through which laser is emitted to destroy the obstructing prostate tissue. 

    • Thulium Laser Enudeation of the Prostate (ThuLEP): This procedure uses a resectoscope through which a different type of laser is used to destroy the obstructing prostate tissue.

    • Transurethral Vaporization of the Prostate (TUVP): This procedure uses a resectoscope through which electric current is passed to destroy the obstructing prostate tissue and seal it to prevent bleeding. 

    • Transurethral Water-jet Ablation (TWJA): Water under high pressure is used to destroy the obstructing prostate tissue

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