What is Prostate:
Prostate is a gland situated below our urinary bladder. It surrounds the proximal part of the Urethra. It secretes certain substances which form part of the semen. This gland is about the size of the phalanx of the thumb and weighs about 18 to 24 grams in an adult.
What is Prostatic Hypertrophy:
The Prostate starts enlarging from the age of 40. As it enlarges it constricts the Urethra which is the passage of urine. The enlarged prostate narrows the urethra. This enlargement with aging causing narrowing of the proximal part of the Urethra and causing difficulty in passing urine is called Prostatic Hypertrophy.
What are the symptoms of Enlarged Prostate:
Enlarged prostate causing obstruction causes following symptoms:
- The speed of passing urine becomes slow. Instead of falling farther the urine falls close to the person passing urine. It lacks pressure
- There is a delay in initiating urination. After reaching the toilet the person has to wait for few seconds for the urination to start.
- The urine flow is not uniformly fast. It stops and starts.
- There is an urgency to pass urine
- There is increased frequency of urination. Classically the patients with enlarged prostate get up more than once during night to pass urine
What is The Treatment of Enlarged Prostate?
- When the Prostate is found enlarged during routing Ultrasound examination it does not immediately need treatment. Treatment is needed only when the patient has above symptoms.
- Modern medicines can greatly reduce the symptoms of enlarged prostate. Urologist will prescribe drugs for the symptoms of enlarged Prostate
- There are some drugs that can reduce the size of the Prostate. But they should consumed for at least 3 months to show clinical improvement of symptoms
- When the patient’s symptoms do not improve with medical treatment and the symptoms are severe to disturb his routine life surgery can be performed
When is Surgical Treatment Indicated:
- When the symptoms are not improved by medicines and the symptoms are severe enough to disturb routine life.
- When stones are formed in the bladder.
- When the patient cannot void urine at all (RETENTION OF URINE)
How is The Surgery Done?
- The surgery is done by endoscopic method (Minimally invasive method) using specialized instruments. It is called Transurethral Resection of Prostate commonly known as TURP
- Rarely open surgery is required for huge Prostatic enlargement
How is Turp Done?
- TURP done under spinal anaesthesia
- Spinal anaesthesia is a method where an injection is given in your back to deliver anaesthetic medicine near your spinal card.
- This makes your legs and lower abdomen numb
- You can talk and interact with the anaesthetist during the procedure
- You can also mover your arms
- The surgery is totally painless
- For performing TURP a tubular instrument called resectoscope is passed through your urethra
- Through special instruments, using electricity your Prostate is cut into small bits and bits are removed
- At the end of the procedure a catheter is placed in your bladder. It is removed after 48 hours
How Long I Should Stay in The Hospital?
- Usually 3 to 4 days
Whar are the Possible Complications of Undergoing the Procedure?
- The procedure is very safe in the modern clinical practice
- However, the risk is related to old age, diabetes, high blood pressure, heart disease, asthma, brain disease or other illnesses if the patient has
- Sometimes blood may be passed in urine which needs treatment if excessive
- There are rare complications related to anaesthesia
- Some patients fail to pass urine even after surgery. The reason may be that there bladder is not acting or some other reason which needs to be investigated