​Prostate Enlargement/Benign Prostatic Hyperplasia

Prostate enlargement is the increase in size of the prostate gland. This is a male-specific gland located below the bladder, around the urethra (the duct by which urine is expelled out of the body).

Prostate enlargement causes difficulty in urination as its development gradually blocks the urethra, and consequent blockage of urine passage. This blockage may lead to urinary tract infections or kidney related medical conditions.

It is usually considered a benign, age-related disease, prevalent among men over fifties.

The symptoms for prostate enlargement usually manifest themselves in the form of urinary complications. They involve frequent urination, urgency to urinate, dribbling of urinary stream, difficulty in initiating urination, blood in the urine and sometimes, an inability to urinate.

It is a common misconception to correlate the size of the prostate gland with the severity of the symptoms. This is not the case. A large prostate could show relatively little symptoms.

The symptoms for prostate enlargement are similar to those of prostate cancer. It is important to consult your doctor for a proper diagnosis. You can consult the medical staff of the Kidney and Bladder Service Line at the Aga Khan University Hospital, for an accurate diagnosis and timely treatment.

You can also consult the medical professionals at the Family Health Service Line for a preliminary examination.

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

The testing phase is usually divided into two parts: preliminary examination and verification tests.

The preliminary examination almost always involves a digital rectal exam where the doctor physically gets a feel of your rectum for estimating the prostate size and looking for any signs of cancer. This test might be followed by a urine test to determine any infections. 

A prostate-specific antigen (PSA) blood test might also be conducted to determine the levels of PSA in the blood. Higher levels might indicate an enlarged prostate. 

Finally a neurological exam might be conducted to identify any nervous system issues that might be causing the urinary problems.

Certain additional tests might be conducted for further confirmation. These are usually more thorough and intensive. A urinary flow test might be conducted by asking you to urinate into a machine designed to measure the flow of the urine. This might be followed by a post-void residual volume test aimed at determining how completely your bladder can empty itself. Finally, in more complex cases, invasive procedures such as cystoscopy might be prescribed.

If you have mild symptoms for prostate enlargement, medication might suffice for treatment. Inhibitor drugs might be prescribed to shrink the prostate size, alpha blockers might be used to relax bladder muscles and further medications might be recommended for erectile dysfunction.

If medication does not prove effective and the symptoms become severe, surgical therapy might be advised. This can happen especially if you have urinary tract obstruction or bladder stones. Surgical therapy may include Transurethral resection of the prostate (TURP) where urethra blockage is removed via inserting special instruments in urethra. If surgery has the chance of endangering your health, an incision based procedure known as transurethral incision of the prostate (TUIP) might be used. This procedure widens the urethra by placing a few cuts on the prostate gland to relieve urine flow. Radio waves might also be used in a procedure called transurethral needle ablation (TUNA). By placing needles into your prostate and passing radio waves through them, this process destroys the enlarged sections of the prostate. Alternatively, if the prostates are small, microwave based transurethral microwave thermotherapy (TUMT) might be used. This therapy inserts electrodes in your urethra which then emit microwaves to destroy the inner part of the prostate gland.

A good alternative to most of the above treatment options is Laser therapy. It has fewer side effects and provides immediate relief. It basically involves projecting a high-energy laser on the overgrown area of the prostate, not only removing it in the process but also preventing its re-growth.

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.