Home arrow Prostate Clinic arrow What is an Enlarged Prostate or Benign Prostatic Hyperplasia (BPH)?
What is an Enlarged Prostate or Benign Prostatic Hyperplasia (BPH)?

The prostate may enlarge with age leading to urinary obstruction. This enlarged prostate is known as Benign Prostatic Hyperplasia or Hypertrophy or BPH for short. As its name, this is a benign prostate enlargement. It is not prostate enlargement as a result of prostate cancer.

As many as half of all men age 50 years old and above may have prostate problem and symptoms suggestive of an enlarged prostate or BPH. These symptoms of an enlarged prostate are collectively called Lower Urinary Tract Symptoms (LUTS).

What are examples of LUTS?

The symptoms of LUTS are:

1.    Frequency
This refers to an increase in feeling the need to urinate.

2.    Urgency
This is a strong and sudden urge to urinate.

3.    Nocturia
Urinating frequently at night is known as nocturia.

4.    Hesitancy
This is difficulty initiating urination.

5.    Weak Stream
This refers to a loss of force in the urine stream.

6.    Intermittency
Stopping and starting again several times during urination is intermittency.

7.    Incomplete Emptying
The feeling of incomplete emptying suggests urine remaining in the bladder after urination.

8.    Terminal Dribbling
This is when residual urine leaks after urination.

These symptoms can also be caused by other conditions besides BPH such as prostate cancer or bladder cancer and infection.

A simple test to see if you suffer from enlarged prostate or BPH is to complete the questionnaire below:

You may wish to consult your doctor for interpretation of the above results and for further information on enlarged prostate BPH.

How will an elarged prostate or BPH affect me?

Men experiencing LUTS and prostate problem may be bothered by their symptoms to different degrees depending on the severity of these symptoms. LUTS may impact their lifestyle and normal daily activities. There are many ways to treat enlarged prostate/BPH and LUTS so as not to interrupt your daily activities. It is important to talk to consult your doctor for the treatment of enlarged prostate / BPH and LUTS that is right for you.

What is the potential harm of BPH?

Without treatment, an enlarged prostate or BPH can continue to grow over time. In severe cases, the enlarged prostate may be so big that the urine cannot flow from the bladder. This complete obstruction is known as acute retention of urine. A soft tube (catheter) may need to be inserted to relieve the obstruction.

More severe consequences of such prostate problem include urinary incontinence, bladder stones, kidney infections and damage to the bladder, kidneys and urethra.

How can an enlarged prostate or BPH be treated?

An enlarged prostate or BPH may be treated medically with drugs or surgically.

medication for enlarged prostate or BPH

There are 2 groups of medication to treat an enlarged prostate problem:

  1. Alpha-blocker
    Alpha blocker relax the urinary passage through the enlarged prostate or BPH allowing easier urine flow and giving relief to men with prostate problem. They have to be taken continuously for a period of time. Examples of alpha blocker are Xatral, Hytrin and Cardura.

  2. 5-Alpha Reductase Inhibitor (ARI)
    This medication help reduce the size of the enlarged prostate. Alpha Reductase Inhibitor also have to be taken continuously as the enlarged prostate may revert back to its initial size when the drug is stopped. Examples of this meidcation to treat enlarged prostate are Avodart (dutasteride) and Proscar (finasteride).


Surgery for Enlarged Prostate or BPH 

The aim of surgery is to remove the obstructing enlarged prostate or BPH resulting in a clear passage for urine flow.

There are various surgery available for enlarged prostate or BPH. These are:

  1. Transurethral Resection of Prostate (TURP)

    In TURP, the enlarged prostate is removed using an electric current flowing through a metal loop inserted into a telescope that is passed up the urinary passage. There is no open surgical wound with TURP.

    The enlarged prostate is removed in small pieces that are sent for analysis to confirm no prostate cancer is present. After TURP, a large smooth cavity is created within the prostate for the passage of urine. The patient usually stays in the hospital 2 days after TURP.

  2. Plasmakinetic (PK) resection of the prostate

    In Plasmakinetic resection, the enlarged prostate is excised with plasma energy developed around a special resection loop connected to the Gyrus generator.

    A plasma corona is generated around the loop such that the enlarged prostate tissue molecules entering this highly energized field are vaporized creating a cutting effect. The PK waveform has been tuned to enable concomitant hemostasis during resection. When retraction of the loop is done at the appropriate speed, sufficient thermal energy remains on the prostate tissue to enable coagulation of capillary bleeders.  The effect gives clear, bleeding free resection

    Significantly lower voltages (220–320Vrms) is used. This is a fraction of the high voltages (1,000–3,000Vrms) used in monopolar TURP designs. The effect is to reduce localized prostate and adjacent tissue damage, preventing charring and damage to underlying blood vessels that may subsequently slough off or open due to patient movement.

  3. PVP Greenlight Laser of the prostate

    PVP or Photoselective Vaporization of the enlarged Prostate using the Greenlight laser is the latest cutting edge technology used to treat prostate problem. PVP Greenlight Laser vaporization of the enlarged prostate employs the Potassium-Titanyl-Phosphate (KTP) Laser or Greenlight Laser Therapy to vaporize prostate tissue.

    The PVP Greenlight Laser vaporization of the enlarged prostate treatment is delivered through a thin, flexible fiber, which is inserted into the urethra through an instrument, called a cystoscope.

    PVP Greenlight Laser vaporization of the enlarged prostate is a minimally invasive therapy and generally requires a hospital stay of less than 48 hours. PVP Greenlight Laser vaporization of the enlarged prostate combines the effectiveness of TURP surgery with a lower risk of side effects and complications. Post-treatment catheterisation is 24 hours (less than the 48 hours in TURP) after PVP Greenlight Laser vaporization of the prostate.

    Over 200,000 PVP Greenlight vaporization of prostate procedures have been performed worldwide by surgeons certified to carry out the procedure. We are certified to perform PVP Greenlight vaporization of prostate.


UroSurgery Mt. E, Urology Specialist Clinic, Singapore





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