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The prostate gland is the walnut-sized organ located above the bladder which manufactures the fluid for semen.
Over time, the bladder wall becomes thicker. The bladder needs to contract even when it contains small amounts of urine, leading to more frequent urination. Finally, the bladder weakens and loses the ability to empty itself.
The most common symptoms of benign prostate disease are:
In addition to the above, the consultant will request an assessment of your urination flow rate, a bladder scan and blood tests to assess kidney function test and the amount of prostate-specific antigen in your bloodstream. In some cases, they will also ask for a bladder pressure test and renal ultrasound screening.
Surgery (standard TURP – transurethral resection of the prostate – and open prostate operations) is the most generally accepted method of treating an enlarged prostate when symptoms are severe. The operation removes some of the tissue to relieve the symptoms. More limited types of surgery make cuts in the prostate instead of removing tissue.
Minimally invasive management approaches include Transurethral Radiofrequency Needle Ablation (TUNA), Transurethral microwave thermotherapy (TUMT), High-Intensity Focused Ultrasound, Transurethral Vapourisation and Laser Prostatectomy. Recently, a new procedure called UroLift has become available, which involves the placement of permanent implants on the prostate with the help of a delivery device. The delivery system is introduced through the urethra to reach the blocked area. The implants are introduced and permanently placed to hold the enlarged prostate tissue away from the urethra, decompressing it.
The UroLift is an alternative to a TURP procedure and intended for men who want to maintain their quality of life and sexual function and avoid major surgery. It may not be recommended, however, in cases where the prostate is too enlarged.
Each treatment carries its own inherent risks. Tablets carry the risks of tiredness, dizziness, headaches and retrograde ejaculation (where the semen is redirected from the urethra to the bladder). Finasteride carries the risk of poor libido and erectile dysfunction. Minimally invasive treatments all carry a certain percentage of risk.