Urinary Retention Lead to Prostate Enlargement
The prostate gland is a male walnut-shaped organ which is located just below the bladder and surrounds the urethra. Some people may be confused with testicles. The testicles are responsible for sperm production while the prostate gland produces whitish seminal fluid that protects the sperms. The prostate grows bigger with age and the level of testosterone. The enlarged prostate can become a problem. Benign Prostatic Hyperplasia (BPH) or prostate enlargement is commonly found in elder males. It begins at the age of 40 and over and up to 90% at the age of 80 – 90. Dr. Karan Rimthephathip, our urological surgeon at Bangkok Hospital Hua Hin shares that the symptoms of BPH are caused by two main factors: the prostate obstruction of the urinary tract and the bladder irritation by it. The symptoms may vary and can present with the following complaints such as weak urine stream, difficulty in starting of urination, interrupted urine stream, dribbling at the end of urination, inability to completely empty the bladder, frequent urination especially at night, inability to hold urine and dysuria which is painful urination. Some patients may not have any warning symptoms and all of the sudden, developing obstruction. How to diagnose Benign Prostatic Hyperplasia (BPH)? When patients develop symptoms and seek medical attention, the doctor will begin by manual examination through the rectal canal known as Digital Rectal Examination (DRE). This is to check and estimate the prostate gland size, along with any abnormalities suggesting cancer nature. The urine analysis is also required to rule out other diseases such as urinary tract infections The further examination is a blood test for PSA (ProstateSpecific Antigen) which is the prostate cancer screening test. This will help to determine the nature of the prostate problems as prostate cancer and BPH share the same symptoms make it difficult to differentiate. This is the reason we suggest that men aged 50 to 75 years should have prostate cancer screening on a yearly basis. Uroflowmetry and residual urine analysis is commonly used to assess the urine stream. The stream reflects the ability of bladder to squeeze itself and poor contraction may increase the risk of urinary tract infections. Moreover, it will be used to compare the results before, during, and after the treatment for BPH. KUB Ultrasound (Kidneys, Ureters and Bladder) is to analyze the urinary tract disorders such as possible masses, kidney and bladder stones. This examination can accurately evaluate the size of the prostate as well. Treatment for BPH After being screened by DRE and PSA test, patients with enlarged prostate, with negative test do not require any treatments. However, they should be monitored every two years by the same DRE and PSA testing. In case that patient has symptoms, treatment are required and can be initiated through behavior modification depending on patient’s conditions. For example, if the patient has to urinate often at night urinating at night, then he should refrain from drinking water, coffee, and tea about 2 hours before going to bed. For treatments by medications, there are various types of medications doctors use to treat prostate enlargement. The choice of medications and doses vary in individuals depending on how well they respond to the treatment. Surgical treatment can be divided into 2 cases; 1. If the result of prostate cancer screening show a risk of prostate cancer, a prostate biopsy is required to prove. The doctor will perform the biopsy using rectal ultrasound probe to locate the prostate, a small biopsy needle will then be inserted into the prostate. The aim for this procedure is to prove the nature of the prostate tissue, not exactly the treatment. 2. Transurethral Resection of the Prostate (TURP) which is the procedure to resect or remove a part of the prostate by inserting the tubal equipment through the urethra under the anesthesia. This procedure will help patients with obstruction of urine flow who do not show improvement from medications or patients with prostate bleeding. Because the instrument is inserted though the urethra, there are no surgical scars and the patient can leave the hospital within 3 to 4 days. Possible Complications If Left Untreated If there are presented symptoms of BPH and without proper treatments, the following complications may occur,
  1. The symptoms will become more severe. If patient has frequent urination at night, it will affect the sleeping quality.
  2. Recurrent urinary tract infections are common in people with BPH because of high amount of residual urine and this is a good source of infection.
  3. Inability to urinate caused by an enlarged prostate. In some patients, kidney failure may develop from the back pressure in the urinary tract system from the blockade.
Benign Prostatic Hyperplasia (BPH) is a condition that can occur in all elderly men. It is important to differentiate the diagnosis of prostate cancer and prostate enlargement. BPH has shared the same symptoms as prostate cancer. Therefore, as soon as these symptoms occurs,  patients should immediately consult a specialist for a proper treatment plan to prevent worsening of the conditions.” Dr. Karan concluded. ************************************************************************** For more information and booking an appointment, please contact : Tel. 032-616-800 Call Center, Bangkok Hospital Hua Hin Tel: 032-616-880 (7.00 – 19.00 hrs.) Out-patient Department, ground floor Line : @bangkokhuahin or https://lin.ee/5tso2l0