WHAT IS BPH?
Approximately half of men over the age of 65 (43%) have benign prostatic hyperplasia (BPH) BPH is a benign (non-cancerous) increase in prostate cells, resulting in the middle parts of the prostate growing progressively.
Prostate enlargement. What changes are seen after?
There is a narrowing in the part of the urethra surrounded by the prostate tissue. For this reason, urine flow decreases and there are difficulties in emptying the bladder. In response to the increasing narrowing, the bladder walls, which consist of muscles, become thicker and stronger. Inner bladder pressure gradually increases in order to overcome the effect of narrowing and to ensure urine flow, and this high pressure causes the formation of vesicles called "diverticula" on the bladder wall.
Can an enlarged prostate cause kidney problems? ?
The increase in pressure rarely extends higher and causes kidney problems.
What happens if BPH goes untreated?
If BPH remains untreated, chronic urinary retention (characterized by the presence of a bladder that expands to take up a large space) or acute urinary retention (a suddenly painful condition in which the flow of urine is blocked) > may develop. In both cases, catheterization and possibly prostate surgery may be necessary.
What are the complaints associated with BPH?
- Intermittent urination (urination by waiting) (when the stream starts and stops)
- Weak urine stream
- Straining while urinating
- Feeling like there is some urine left in the bladder after urinating
- Frequent Frequently going to the toilet and urinating for a long time
HOW IS BPH DIAGNOSED?
Physical Examination and Digital Rectal Examination (DRM):DRM tells your doctor that your prostate is It will give you an idea about its size and consistency. Then, your abdomen will be examined and your bladder will be felt if it is enlarged.
Urinary Analysis:Since urinary tract infection may occur in the form of frequent urination, the urine sample will be examined for signs of bacterial infection and the presence of blood.
Blood Tests: By measuring the level of a substance called creatinine in the blood, it is determined whether the kidneys
are affected. PSA level can also be measured.
PSA is a marker indicating prostate damage and may increase due to prostate cancer, ;BPH. If your PSA level is high, a biopsy may be recommended to rule out prostate cancer.
Measuring urine output rate over time provides useful information about your urine flow. While this test is being performed, you will be asked to urinate into a container belonging to a device known as uroflowmetry.
Ultrasound measurement of the urine remaining in the bladder
This method tells your doctor about the degree of obstruction and some treatments. It gives an idea about your response.
Transrectal ultrasonography (TRUS)
It can be used to view the prostate, measure its dimensions and guide the biopsy needle if cancer is suspected. .
Treatment
BPH is treated with medications or surgery.
- MEDICATION TREATMENT
- SURGICAL TREATMENT
- TURP
In this technique, a device that can emit electric current, plasmakinetic or other different energies is passed through the penis and advanced towards the prostate and the enlarged prostate is removed. The middle parts of the prostate are removed in pieces. At the end of the operation, a catheter is passed through the ureter and placed into the bladder to ensure urine drainage and is left in place for a few days. The normal hospital stay after TURP is 2 or 3 days. You should get used to resting as much as possible for a week after the surgery.
After the surgery, an urgent need to urinate and/or the feeling of urinating may occur. These symptoms should disappear within a few weeks. You may also have blood in your urine. While this is normal, if your bleeding is heavy, lasts longer than a few weeks, or you notice blood clots in your urine, start drinking plenty of fluids and see your doctor. A condition that can often be seen after surgery is retrograde ejaculation, which can be described as the flow of sperm fluid back into the bladder after orgasm instead of coming out of the penis. Therefore, when you urinate, the sperm fluid will be excreted with the urine. This is not a condition that harms the body.
A study comparing patients who underwent TURP due to BPH with BPH patients who did not undergo surgery. In the study, the number of men reporting erection problems was similar in both groups. Some patients even reported improvement after surgery. If you notice urine leakage after TURP, you should contact your doctor. This problem disappears immediately over time.
Open prostatectomy
It is the most suitable approach for patients with very large prostate or large bladder stones. The prostate is accessed by making a horizontal incision in the lower part of the navel. The middle part of the prostate is removed through an incision made in the bladder and prostate. During the surgery, a catheter is placed in the bladder to provide urine flow and is left in place for about 4-5 days. You will need to stay in the hospital for about 3 days during this procedure. After discharge, you will be asked to rest for about 1 week and not engage in activities such as heavy lifting. An incision scar will be formed at the surgery site. Retrograde ejaculation (semen flowing back into the bladder) may also occur after open prostatectomy.
Laser prostatectomy
This method is also As described in the TURP method, a device that emits laser energy is advanced through the penis and towards the prostate, and the middle parts of the prostate are vaporized with the laser energy.
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