Benign Prostate Hyperplasia
What Are the Signs of BPH?
- Difficult urination, delay in starting urination
- Cessation and resumption of urination
- Dripping more than normal at the end of urination
- Feeling incomplete after urinating
- Waking up to urinate at night
- Difference in urine flow/calibration compared to the past
- Sudden urge to urinate and sometimes incontinence
What Are the Tests to Be Done for BPH?
- Digital rectal exam
- Blood PSA, urea and creatinine levels
- Urinary tests (urine flow rate and residual urine measurement)
- Urinary ultrasonography for the examination of the kidneys, urinary tracts, bladder and the prostate
- Urodynamic studies if needed (a study that evaluates the flow and storage functions of the bladder)
Treatment of BPH
The condition that requires treatment in BPH is not the prostate enlargement, but the complaints related to the blockage of the bladder outlet. Even if the prostate is enlarged, it may not block the bladder outlet and treatment may not be required. However, on the contrary, a slightly enlarged prostate may cause obstruction in the urinary bladder outlet that requires treatment.
If the quality of life is negatively affected by the symptoms mentioned above or bladder outlet obstruction due to BPH, treatment is required.
- Surveillance: It is performed at regular intervals to follow-up complaints and evaluate bladder outlet obstruction. Patients with mild complaints, normal PSA values and no suspicious prostate examination can be included in the annual follow-up protocol.
- Medical Treatment: Treatment is provided by using drugs that relax the smooth muscles in the prostate and bladder outlet or by drugs that facilitate urinary flow with hormonal effects. Thanks to these drugs, complaints can be improved and urine flow rate can be increased.
- Surgical Treatment (Endoscopic or Open Prostate Surgery)
Indications for Surgery:
- Inadequate response to medical treatment
- Severe complaints and very poor quality of life
- Recurrent urinary tract infections due to BPH
- Recurrent obstructions due to BPH (being unable to urinate)
In the presence of these indications, prostate surgery is recommended. Today, thanks to technological developments, endoscopic surgeries are the most widely used surgical techniques. Prostate surgeries performed with the open surgical method (with an incision through the skin) are performed if the size of the prostate has drastically increased and are rarely preferred.