prostate enlargement

Symptoms, Treatment And Lifestyle Changes For Prostate Enlargement In Men

Prostate enlargement affects almost half of the men above the age of 50. The condition is called Benign Prostatic Hyperplasia (BPH).

Gaurav Sinha (57), however, didn’t have any clue about it until he started noticing a change in his urinary pattern.

“It has been a month since I started waking up almost 5 to 6 times at night with an urgent need to urinate. Even though my bladder felt full, I faced difficulty in passing urine, “ Gaurav shared.

“Despite frequent trips to the washroom, I was unable to empty my bladder completely which added to my discomfort.”

The situation got worse when one day he was unable to pass urine at all. He just could not urinate despite repeatedly visiting the toilet and straining himself. Within 3 to 4 hours he developed excruciating pain in his lower abdomen as his bladder bloated due to the stored urine.

Symptoms of enlarged prostate:

prostate enlargement

He rushed to Dr. Rajesh Khanna, Senior Urologist at Sitaram Bhartia Hospital in South Delhi for a consultation.

Prostate Enlargement – How is it diagnosed?

On listening to Gaurav’s symptoms and keeping his age in mind, Dr. Khanna suspected an enlarged prostate and decided to carry out a Digital Rectal Examination (DRE) to physically check if his prostate had increased in size. He discovered a moderate enlargement on performing DRE.

He then advised Gaurav to get an ultrasound of the kidneys, ureter, bladder and prostate. The prostate size on ultrasound was found to be 52cc where the normal size of prostate is around 30 cc.

“In patients who present early with the difficulty in passing urine we also measure the post void residual urine volume (amount of urine left in the bladder after urination) and conduct a uroflowmetry to measure the flow and force of the urinary stream,” said Dr. Khanna.

For a proper diagnosis, Prostate-Specific Antigen (PSA) blood test was also conducted. PSA is a substance produced in your prostate. PSA levels increase when the prostate gland enlarges. Abnormally high levels raise the suspicion of prostate cancer. Kidney function tests were also done to document any damage to the kidneys and a urine culture to rule out any infection.

All the test results revealed that Gaurav indeed had an enlarged prostate gland without any kidney damage.

What is Prostate Enlargement?

Prostate is a walnut-shaped gland situated at the base of your bladder surrounding the urethra (tube transporting urine from the bladder out of the penis) and is responsible for making the fluid that goes into the semen.

“Prostate gland gland grows throughout the life of a man but when it becomes very enlarged, it starts putting pressure on the urethra and blocks the flow of urine” explained Dr. Khanna.

Prostate enlargement

Gaurav understood why he had trouble beginning to pass urine. He inquired about why the condition develops.

What causes the prostate to enlarge?

“Studies have shown that the prostate gland grows due to hormonal changes that take place with age. Testosterone levels have shown some correlation as well”.

Gaurav had heard about prostate cancer and hence was worried that his condition might lead to cancer.

“Having BPH doesn’t increase your chances of developing prostate cancer at all,” clarified Dr. Khanna.

After Gaurav fully understood his condition, he was ready to discuss the treatment with the doctor.

BPH Treatment – Can prostate enlargement be cured?

There are different methods that can be used to prostate enlargement treatment but it all depends on the symptoms of the person, his age and size of his prostate.

Medication vs Surgery for BPH

When a person shows only mild to moderate symptoms without any complications, he can simply be treated with the help of medication. But if he shows severe symptoms, prostate surgery becomes essential.

Since Gaurav’s prostate was quite enlarged and he had lost his ability to urinate, he had to start with a catheter (thin tube) which was inserted inside his urethra and into the bladder to pass all the urine stored in it. 

He was prescribed a medication called 5-alpha blocker and was asked to come back after 2 weeks for a catheter- free trial.

After 2 weeks when the catheter was removed, Gaurav was asked to try passing urine again.

When he was still unable to do so, Dr. Khanna advised him to go for a minimally invasive surgery known as Transurethral Resection Of Prostate (TURP) instead.  

Alarmed at the mention of surgery, Gaurav asked many questions about how it would be performed and about post -operative care.

“We insert a surgical instrument called a resectoscope through the tip of your penis and into the urethra. The resectoscope is then used to scrape away excess of the prostate gland which is blocking the urine flow,” explained Dr. Khanna.

HoLEP Treatment for Prostate Enlargement – Holmium Laser Prostate Surgery or Holmium Laser Enucleation of the Prostate (HoLEP) is another minimally invasive treatment option for men with enlarged prostate.

This procedure uses laser to entirely remove the prostate tissue that is blocking the urine flow without making any cuts.

The Holmium laser approaches the prostate through the urethra and peels off the part which is obstructing the urinary flow. This gives maximum relief from the prostate obstruction.

After understanding the procedure in detail, the next thing Gaurav was concerned about was how much he’d have to spend for the entire treatment.

What to expect after surgery?

In most cases, you can be discharged after 3-5 days of the surgery. You will be advised not to indulge in any physical exercise or lift heavy things.

“You should also avoid traveling in buses and other public transport where there is a chance of getting pushed around.”

Gaurav discussed all the details of the surgery with his wife and together they scheduled the surgery. 

Fortunately, his surgery went well.

In the follow-up consultation, he asked about what can be done to control the symptoms of an enlarged prostate at home so that he could advise his friends and family about the condition.

Dietary changes to manage symptoms of Prostate Enlargement

“I don’t prefer to restrict my patients in terms of diet but anything in excess is also not good,” remarked Dr. Khanna.

Make the following dietary changes to control your symptoms better: 

    • Limit your liquid intake in the evenings:  Avoid drinking lots of water in the evenings. It would be better to not drink anything for at least two hours before bedtime. This will help you reduce your trips to the washroom at night.
    • Have a healthy meal everyday: Avoid oily and junk food as it can cause obesity. Obesity increases chances of having an enlarged prostate. Eat lots of fresh fruits and vegetables daily. Also try to limit your intake of red meat like beef, pork and lamb. Choose healthier sources of protein like fish and eggs. 
  • Avoid caffeine and alcohol: These can increase urine production and worsen the symptoms. Alcohol causes prostatic congestion and can increase the chances of urine retention in borderline cases.

“Thankfully I feel a lot better after the surgery. Now I know the importance of treating prostate enlargement early,” remarked Gaurav.  

“I will advise all my friends to go for a prostate check-up so they can get treated if needed before complications arise as they did in my case,” said Gaurav.