Enlarged Prostate (BPH) Treatment in Delhi, India

The symptoms of prostate enlargement vary, but the most common ones involve changes or problems with urination, such as:

1. Having to urinate more often (frequency)
2. Getting up several times at night to urinate (nocturia)
3. Need to rush to the toilet (urgency)
4. Difficulty in starting to urinate (hesitancy)
5. A weak stream
6. Interrupted flow of urine (intermittency)
7. Dribbling on underwear
8. Discomfort or burning sensation when urinating
9. Urinary incontinence (Lack of control)
10. Feeling that bladder has not emptied properly
11. Having to strain while passing urine

These symptoms are analysed based on a symptom score, and the result of this score classifies the symptoms into mild, moderate and severe. The size of the prostate does not always determine the severity of the obstruction or symptoms. Some men with greatly enlarged glands have little obstruction and few symptoms while others, whose glands are less enlarged, have more blockage and more significant problems.

At Max Healthcare, we offer comprehensive treatment for various urological conditions. Our state-of-the-art facilities, we specialize in providing services in the areas of urology, uro-oncology, reconstructive urology, robotic surgery, kidney transplantation & laparoscopic andrology services, among others. Some of our exceptional services include laparoscopic urological surgery, ABO-incompatible kidney transplantation, renal transplantation, uro-oncology, reconstructive surgery of the urinary tract, and laser urological procedures.

Additionally, we have the intuitive surgical Da Vinci XI Robotic System to perform highly complex urological procedures like radical cystectomy, radical prostatectomy, partial nephrectomy, etc. All urological surgeries are performed laparoscopically to ensure great precision for improved patient outcomes.

Our dedicated team of leading urologists provides the most advanced treatments using cutting edge technology, based on international standards. They have years of experience under the belt, including international level experience and exposure.

BPH is not cancer. But some of the symptoms of an enlarged prostate and prostate cancer are similar. In 8 out of 10 cases, these symptoms suggest prostate enlargement, but they may also be due to prostate cancer. Hence, diagnosis plays the most important part in the treatment approach for enlarged Prostate.

The diagnosis tests vary from patient to patient, but the following are the most common tests performed:

1. Digital Rectal Examination (DRE): This examination is usually the first test done. The doctor inserts a gloved finger into the rectum and feels the part of the prostate next to the rectum. This examination gives the doctor a general idea of the size and condition of the gland.
2. Ultrasound: It involves generating echo patterns of the sound waves, which form an image of the Prostate gland on a display screen.
3. Urine Flow Study: The patient will be asked to urinate into a special device that measures how quickly the urine is flowing.
4. CMG (Urodynamics): It involves the use of a series of investigations that can identify the cause of urinary bladder control problems. These investigations are required in patients with prostate enlargement with urine outflow obstruction.

When prostate enlargement is suspected, you may be referred to a urologist, a doctor who specializes in problems of the urinary tract and male reproductive system. Your doctor can rule out cancer with the help of a detailed examination and certain investigations.

You may be recommended a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have Prostate cancer. Such tests also help decide whether surgery is needed.

Follow-up after Enlarged Prostate (BPH) Treatment

Following surgery, you will stay in the hospital from 2-4 days depending on the type of surgery you had and how quickly you recover (after TURP, the average hospital stay is 36 to 48 hours). Open surgery requires almost 7-8 days of hospital stay.

The Urologist at Max Healthcare decides the modality of treatment for a particular patient after detailed examinations and investigations. There are two main ways of enlarged prostate treatment:

1. Non-surgical Treatment

   Over the years, researchers have tried to find a way to shrink or at least stop the growth of the prostate without using surgery. FDA has approved some drugs to relieve common symptoms associated with an enlarged prostate. These medications act by relaxing the smooth muscle of the prostate and bladder neck to improve urine flow and to reduce bladder outlet obstruction.

2. Surgical Treatment

   Most doctors recommended removal of the enlarged part of the prostate as the best long-term solution for patients with prostate enlargement. With surgery for prostate enlargement, only the enlarged tissue that is pressing against the urethra is removed. Surgery usually relieves the obstruction and incomplete emptying caused by prostate enlargement. The types of surgery that are used are as follows:-

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  In this type of surgery, no external incision is needed. After giving regional anaesthesia, the surgeon reaches the prostate by inserting an instrument called a resectoscope through the penis. The surgeon uses the resectoscope’s wire loop to remove the obstruction tissue one piece at a time.

• Other Endoscopic procedures

  TUIP (Transurethral Incision of Prostate) and TUEVP (Transurethral Electrovaporization of Prostate) are endoscopic surgical procedures for patients with smaller Prostates. TUEVP is equivalent to laser surgery.

• LASER Surgery

  HO Laser (Holmium Laser) enucleation of the prostate is done to remove the gland through the endoscopic method as done in open surgery. Like TURP, it requires anaesthesia and a hospital stay. At Max Healthcare, we perform the world’s most advanced Holmium Laser (HoLEP) Surgery which is done to remove the enlarged prostate gland tissue. The VersaPulse® is a unique device that allows the doctor to perform certain surgical procedures with increased precision, smaller or no incisions, and little or no bleeding.

• Open Surgery

  In a few cases when a transurethral procedure cannot be used, open surgery, which requires an incision, may be used. It is done when the gland is greatly enlarged, when there are complicating factors, or when the bladder has been damaged and needs to be repaired.

Max Healthcare is one of the best hospitals which provides BPH treatment after understanding BPH causes & symptoms of prostate enlargement. Get all detailed information about treatment and medicine for prostate enlargement. 

1. When to Get Prostate Surgery Done?
2. Does Diet Play an Important Role in Preventing Enlarged Prostate?
3. An Enlarged Prostate Can Cause Trouble Urinating

What is Benign Prostatic Hyperplasia (BPH)?
Benign Prostatic Hyperplasia (BPH) refers to the non-cancerous enlargement of the prostate gland, a walnut-sized organ located beneath the bladder in males.

What causes BPH?
BPH is primarily caused by age-related hormonal changes, particularly an increase in dihydrotestosterone (DHT), which leads to the overgrowth of prostate cells.

What are the common symptoms of BPH?
Common symptoms include frequent urination, difficulty starting and stopping urination, weak urine stream, nocturia (frequent urination at night), and a feeling of incomplete bladder emptying.

How is BPH diagnosed?
Diagnosis often involves a combination of medical history review, physical examination, digital rectal exam, urine flow studies, and imaging tests like ultrasound or cystoscopy.

Is BPH a precursor to prostate cancer?
No, BPH itself does not increase the risk of prostate cancer. However, the two conditions can coexist in some individuals.

What are the treatment options for BPH?
Treatment options range from watchful waiting for mild cases to medications (alpha-blockers, 5-alpha reductase inhibitors), minimally invasive therapies (laser therapy, UroLift), and surgical interventions (transurethral resection of the prostate - TURP).

How do alpha-blockers work in treating BPH?
Alpha-blockers relax the smooth muscles of the prostate and bladder neck, thereby improving urine flow and reducing symptoms.

What are 5-alpha reductase inhibitors used for?
These medications reduce the production of DHT, which can help shrink the prostate gland and alleviate BPH symptoms over time.

Can lifestyle changes help manage BPH symptoms?
Yes, lifestyle changes like limiting caffeine and alcohol, managing fluid intake, and regular exercise can help manage BPH symptoms.

What is transurethral resection of the prostate (TURP)?
TURP is a surgical procedure in which excess prostate tissue is removed through the urethra to relieve urinary obstruction.

What is the UroLift procedure?
UroLift is a minimally invasive procedure where tiny implants are used to hold the enlarged prostate tissue away from the urethra, reducing symptoms.

Are there any natural remedies for BPH?
Some studies suggest that certain herbal supplements like saw palmetto and beta-sitosterol may provide modest relief of BPH symptoms, but more research is needed to establish their efficacy.

Can BPH be prevented?
There's no surefire way to prevent BPH, but maintaining a healthy lifestyle, staying physically active, and avoiding excessive alcohol and caffeine intake may help reduce the risk.

Are there any complications associated with untreated BPH?
If left untreated, BPH can lead to urinary tract infections, urinary retention (inability to urinate), bladder stones, and kidney damage.

Can BPH be diagnosed in younger men?
While BPH is more common in older men, it can occasionally occur in younger individuals. Proper diagnosis is important to rule out other potential causes of urinary symptoms.

What role does DHT play in BPH?
DHT, a hormone derived from testosterone, stimulates the growth of prostate cells. Elevated DHT levels contribute to the development of BPH.

What is the International Prostate Symptom Score (IPSS)?
The IPSS is a questionnaire used to assess the severity of BPH symptoms and guide treatment decisions.

How often should men get screened for BPH?
Routine screening for BPH is not recommended. However, men over 50 should discuss urinary symptoms with their healthcare provider.

Is sexual dysfunction associated with BPH treatment?
Some medications used to treat BPH, particularly 5-alpha reductase inhibitors, can be associated with sexual side effects like decreased libido and erectile dysfunction.

Can BPH return after treatment?
Yes, BPH symptoms can return even after successful treatment, necessitating ongoing monitoring and management.

Review

FAQs reviewed by Dr. Yashdeep Rustagi, Principal Consultant - Urology, Robotic Surgery.