Benign Prostatic Hyperplasia (BPH), also known as prostate gland enlargement, is a common condition that affects aging men. It occurs when the prostate gland, which is a walnut-sized gland located below the bladder, grows in size. This enlargement can lead to various urinary symptoms due to the gland pressing against the urethra (the tube that carries urine from the bladder out of the body). BPH is a non-cancerous condition.
Here are some frequently asked questions by the patients regarding benign prostate hyperplasia:
- What is BPH (Benign Prostatic Hyperplasia)?
Answer – It is gradual enlargement of the prostate as men grow older leading to urinary symptoms, it is purely benign in nature. - Why does prostate enlarge in size?
Answer – Prostate is located beneath the bladder and completely surrounds the urethra all around. It is not completely clear why prostate increases in size as men age, but it is related to changes in sex hormones leading to its growth in old age. - What are the symptoms of BPH?
Answer – Common symptoms include:- Increase frequency of urine, especially at bedtime (nocturia)
- Urgent need to urinate
- Difficulty in starting urination
- Thin stream of urine or a stream that stops and starts
- Straining during urination
- Intermittent urination
- Dribbling after urination
- Feeling of incomplete emptying of bladder after urination
Some less common symptoms are:
- Not able to urinate
- Blood in urine
- Urine infection
- Does size of prostate have correlation with prostate related symptoms?
Answer – Size of prostate have no correlation with symptoms. There are patients with small prostate size with severe symptoms and others with large glands and still completely asymptomatic. - What will happen if I don’t take treatment for BPH?
Answer – It can lead to various sequelae:- Urinary retention
- Urinary tract infections
- Bladder stones
- Urinary damage
- Kidney damage
- For how long is the risk of bleeding after surgery?
Answer – Bleeding can occur up to 4 weeks after surgery, but its chances decreases significantly by each passing day. Risk is highest just after surgery, minimal during first week and rare later. - What precautions can be taken to reduce the chances of bleeding?
Answer – Patient has to keep the Foley catheter with utmost care if discharged with it. There are high chances of its getting stretched when patient usually changes position. Patient has to be really conscious till the time catheter is there.
Constipation must be avoided with/ without medicines, straining during passage of stools can cause bleeding
Lifting of heavy weight/ heavy exercises should be avoided for 4 weeks. - Dietary recommendation after surgery
Answer – There are no specific dietary modifications required for surgery except the need for high fiber intake to reduce chances of constipation.
Patient already on some dietary recommendation before surgery (e.g. Diabetes/ Hypertension) for other diseases should follow the same as before. - Difference between monopolar and bipolar TURP?
Answer – In bipolar TURP, both the active and passive electrodes are within the resectoscope, whereas in monopolar TURP, the return electrode is the patient body itself. Although the improvements in flow rate and decrease in symptoms appear to be similar between the two techniques, chances of bleed are less with bipolar resulting in early catheter removal and decrease hospital stay. - What is the success rate of TURP?
Answer – Success after TURP is usually defined is terms of improvement in flow rate and decrease in symptoms due to BPH. There is an average increase in flow rate around 125 – 175% and decrease in symptoms by 75%. - How long does frequent urination last after TURP?
Answer – It is a surgical procedure which causes inflammation and irritation. This will gradually subside in approximately 4-6 weeks from surgery. - What is TUR syndrome?
Answer – During surgery, too much absorption of irrigation fluids can lead to decrease sodium levels in blood leading to confusion, nausea, vomiting, visual changes, hypertension and tachypnea. It is uncommon seen in only 2% of patients undergoing monopolar TURP and is reversible with medication. Since, saline is used as irrigation medium in bipolar, so its occurrence with bipolar is extremely rare. - Chances of redo surgery after TURP?
Answer – Although a lot of prostate is removed during TURP surgery, it can re-grow slowly. Usually 8-10% patients require re-surgery within 10 years of BPH related symptoms. - Is incontinence normal after TURP surgery?
Answer – Around 30-40% patients might experience incontinence after surgery that is transient in nature. The incidence of late stress urinary incontinence is low 0.6-2%. - What is the recommendation regarding fluid intake in BPH patients?
Answer – It is advised to take 6-8 glasses of water per day in patients suffering from prostate related symptoms. It is also advised to restrict fluid intake 2-3 hours before going to sleep to avoid waking up at night to urinate repeatedly. Coffee and tea should be avoided in these patients as they are bladder irritants.
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