What is prostate?
Prostate is the organ that is part of the urogenital system in our body. It is located under the bladder and the urinary tract passes through it. The function of the prostate in the body is to contribute to the volume of semen containing sperm.
What is benign prostate enlargement?
The volume of prostate tissue increases with age. For example, in a man in his 40s, the prostate volume is the size of a chestnut, in his 50s it is the size of an apricot, and in his 60s-70s; reaches the size of a lemon. This growth puts pressure on the urinary tract, causing some complaints about storing urine in the bladder and urinating.
Aging and genetic predisposition are closely related to benign prostate enlargement.
What are the symptoms of benign prostate enlargement?
These symptoms include difficulty in urinating, thinning of urine, frequent and intermittent urination, sudden urge to urinate, waking up to urinate at night, and the feeling of incomplete emptying of the bladder.
Usually one or more of these symptoms are found simultaneously in patients. All of these complaints are called “lower urinary tract symptoms (LUTS)”.
What methods are used to evaluate benign prostate enlargement?
Digital rectal examination: With this examination, the presence of prostate cancer is investigated, as well as the evaluation of prostate size. International Prostate Symptom Score
(UPSS): It is an evaluation form used to better understand the seriousness of the patient’s complaints. After the patient answers the questions in this form, a simple scoring is made. In this way, complaints are classified as mild, moderate and severe. Additionally, if necessary, you may be asked to fill out a voiding diary.
Blood and urine analyses: Prostate specific antigen (PSA) value is determined as a blood analysis and creatinine level is determined as an indicator of kidney function. PSA is an enzyme secreted by the prostate that liquefies the semen. Its level in the blood increases in cases such as benign prostate enlargement, prostate cancer or prostate infection/inflammation. When PSA elevation is detected; Before prostate-specific treatments, the presence of prostate cancer should be excluded by further evaluation methods. It is recommended that the PSA test be performed after the age of 45 if there is a family history of prostate cancer, or after the age of 50 and repeated at certain intervals.
On the other hand, if the prostate prevents the bladder from emptying, the excess amount of urine remaining in the bladder may cause kidney function to deteriorate. In order to evaluate this situation, serum creatinine value is checked.
Uroflowmetry test: The purpose of this test is to measure the speed of urination. After the patient becomes trapped, he urinates into a urinal-like device. A urination rate below 10 ml/second suggests that there may be a serious obstruction in the urinary tract.
Ultrasonography: With ultrasonography, the size of the prostate, its effects on the kidneys and the amount of urine remaining in the bladder after urination are evaluated.
In addition, if the physician deems it necessary, he may recommend visual evaluation of the urinary tract with cystoscopy or investigation of bladder functions with urodynamics test. All of the mentioned diagnostic methods are available in our clinic.
How is benign prostate enlargement treated?
Drug treatment: The treatment approach for benign prostate enlargement is made according to the patient’s age, size of the prostate, degree of complaints and general health condition. According to the patient’s history and UPSS, recommendations are made only for prostate health in patients with mild complaints, while drug treatment is given to moderately symptomatic patients, and severely symptomatic patients who do not respond to drug treatment; Surgical treatment is recommended. The drugs used in medical treatment may vary depending on the complaints of the patients. The drugs used in this area are drugs that relax the prostate (alpha-blockers), shrink the prostate (5-alpha reductase inhibitors) and bladder (anticholinergics). In addition, in cases where erectile dysfunction is accompanied, tadalafil treatment may also be recommended.
After our evaluation as a physician, they will share their opinions about which drug is suitable for you.
Surgical treatment: If the patient has to have a catheter inserted, has a bladder stone, the patient’s kidney functions are affected, has frequent urinary tract infections, or does not benefit from drug treatment, surgical treatment is recommended for the patient. Surgical treatments recommended by Uropark physicians include transurethral resection of the prostate (TURP), laser prostatectomy (Thulep) and Rezum procedure (reduction of the prostate with hot water vapor).
TURP surgery is a classical surgical technique, in which the part of the prostate that blocks the urinary tract is scraped out in small pieces with the help of electric current. It is recommended for patients with a prostate size up to 100 grams. Laser prostatectomy has advantages such as being able to be performed on larger prostates, less bleeding, and shorter catheterization time. On the other hand, the Rezum procedure; It stands out with its short operation time, no effect on sexual functions, and no need for hospitalization. You can get information about all 3 treatment methods from Uropark physicians or benefit from the brochures we have prepared on these subjects.
How and how often is benign prostate enlargement monitored?
Patients receiving medication are invited for a check-up after 2 months. In this control, the patient’s complaints are evaluated. The UPSS is requested to be filled in again and the uroflowmeter test is repeated. If the patient has benefited from the treatment, he is called for a check-up once a year. After surgical treatment, patients are invited for a check-up at the 1st week, 2nd month, and once a year thereafter.
