The following are the tests done for diagnosing the enlarged prostate:
- You will be questioned in detail about your symptoms.
- A digital rectal exam may be held to determine whether a person’s prostate is enlarged or not.
- A urine test or urinalysis is another test that can help rule out an infection or other conditions that may result in similar symptoms.
- Transrectal ultrasound – Another ultrasound test that will provide measurements of one’s prostate and reveals the particulars about the anatomy of the prostate.
- Prostate-specific antigen (PSA) blood test – In its normal functioning, a prostate gland produces Prostate-specific antigen (PSA), and it helps liquefy semen. However, with an enlarged prostate, PSA levels in semen increase too. Please note that increased PSA doesn’t necessarily mean enlarged prostate as the levels may also get elevated by other reasons like prostate cancer, surgery, recent tests, or prostatitis (an infection).
- Urinary flow test – As the name suggests, the test measures the strength and overall amount of your urine flow.
- Post-void residual volume test – This test checks whether a man can completely empty his bladder. The test involves using an ultrasound to measure the urine left in your bladder.
- Prostate biopsy – The prostate biopsy involves using transrectal ultrasound to guide the movement of a needle that takes tissue samples of your prostate. Examining the tissues from a biopsy using a microscope can help diagnose or rule out prostate cancer.
- Urodynamic and pressure flow studies – These medical procedures involve using a catheter threaded through a person’s urethra into your bladder. Water or air is slowly injected into the bladder to allow the physician to measure the bladder pressures and to determine how well your bladder muscles are working.
Once the diagnosis has been made, there is a choice between surgical and non surgical treatment for BPH.
Prostate Surgery Non-Cancerous Prostate Enlargement Treatment Options:
With prostate surgery, non-cancerous prostate enlargement can be treated. There are many good options for doing this.
Firstly, we must mention that getting treatment is not necessary as long as the enlarged prostate doesn’t also result in symptoms. A prostate surgery non cancerous might result in some undesirable side-effects. Now let us consider the various surgical options:
- Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate (TURP) is the most common medical procedure used over the years to treat this problem. However, it can only be performed when prostates are no more than 60 cubic centimetres in size. The surgery is often the default practice, and other less common options are often compared with it. The surgery involves the surgeon placing a unique lighted scope called a resectoscope into one’s urethra. He then uses small cutting tools to remove all but the outermost part of the prostate – the procedure is called prostate resection. TURP will generally provide relief from symptoms quickly.
Unfortunately, this surgery is not without possible complications, including heavy bleeding for a few days afterward. There may be a chance of infection, and you might be forced to need a caterer to detail your bladder. And you can’t do any heavy activities till the bleeding completely stops. Erectile dysfunction, urinary incontinence, and water intoxication are other common complications.
Transurethral Resection of the Prostate (TURP) is only done where prostates are not too large. An open prostatectomy might be necessary if the prostate is too large or if bladder damage or other factors like bladder stones are involved. Openness means the surgeon will make an incision in the patient’s lower abdomen to reach his prostate. Open prostatectomy has been considered the most effective treatment for men with severe prostate enlargement issues, but it also has several high risks of side effects and complications. The patient is typically expected to stay in the hospital for a few days, and there is an increased risk of blood transfusion.
Laser therapy or laser surgery, as its name suggests, involves using high-energy lasers to destroy or remove the overgrown prostatic tissue. Laser surgery is generally likely to relieve the symptoms right away, and one may have a lower risk of side effects than one does Transurethral Resection of the Prostate (TURP). Laser surgery can be used in men who otherwise can’t have other prostate procedures because they are taking blood-thinning medications for some reason or other.
Laser therapy, too, is without its potential side effects, including the semen flowing backward into the bladder instead of out through the penis during ejaculation – called retrograde ejaculation, the loss of bladder control, or incontinence and even impotence by erectile dysfunction. And these side effects are pretty standard, too – that’s why laser therapy is not generally recommended to patients.
- Nonsurgical Treatment of Enlarged Prostate
So far, the discussion should suggest that all surgical treatments have varying side effects. Fortunately, a new procedure has recently been developed that provides results comparable to Transurethral Resection of the Prostate (TURP) in recovery from the symptoms but without any side effects. It is called Prostatic Artery Embolization or PAE and is available as a non-surgical treatment for enlarged prostate in Mumbai. During this non surgical treatment of enlarged prostate, the patients have first admitted to the hospital after all basic investigations. Some pain medication, anti-inflammatory drugs, and antibiotics are given during the embolization procedure.
Embolization is performed under local anaesthesia by a unilateral approach, usually in the right radial artery in the wrist.
Initially, pelvic angiography is performed to evaluate the prostatic arteries. Then, another four or 5-Fr angiography catheter is introduced to reach the prostatic artery, while a 2-Fr coaxial microcatheter is advanced in the ostium of the prostatic artery. For embolization, non spherical PVA particles or embospheres are used.
The endpoint chosen for embolization is slow flow or near-stasis, which occurs in the prostatic vessels with an interruption of the arterial flow and a prostatic gland opacification. After the embolization of both prostatic arteries is finished, the healthcare provider will remove the catheter. After a few hours (four to six), the patient can start walking around the room without needing a urinary catheter. By the end of the day, he can generally resume his normal activities. The Whole procedure will be done through a small nick around the skin in the groin region and will leave no ugly scars.
After embolization, the shrinkage of the enlarged prostate should occur in 2-3 weeks. Thus, it is an effective non surgical treatment for BPH.
