Healthcare: Urology Services

Benign Prostatic Hyperplasia (Enlarged Prostate)

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Baylor College of Medicine
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Dr. Mohit Khera, a leading urologist at Baylor College of Medicine, explains benign prostatic hyperplasia (BPH): the symptoms, causes, and treatment options for men with an enlarged prostate.

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Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate, is a common condition in older men. It occurs when the prostate gland grows in size, causing compression of the urethra. Symptoms may include frequent urination, weak urine flow, and difficulty starting or stopping urination. While BPH is generally non-cancerous, it can significantly impact quality of life. Treatment options range from lifestyle modifications to medications and surgical procedures.

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Diagnosis of an enlarged prostate

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Benign Prostatic Hyperplasia (BPH) is diagnosed through a combination of medical history, physical examination, and specific tests. Here are the key diagnostic methods:

Medical History: The doctor will ask about your symptoms, urinary habits, and any related health issues.

Digital Rectal Examination (DRE): The physician checks the prostate by inserting a gloved finger into the rectum to assess its size, shape, and texture.

Prostate-Specific Antigen (PSA) Test: A blood test measures PSA levels. Elevated PSA levels can indicate prostate enlargement or other conditions.

Urinalysis: Analyzing a urine sample helps rule out infections or other urinary problems.

Uroflowmetry: This test measures urine flow rate during urination. Reduced flow may suggest BPH.

Post-void Residual (PVR) Measurement: Ultrasound or catheterization determines how much urine remains in the bladder after voiding.

Transrectal Ultrasound (TRUS): An imaging technique that provides detailed images of the prostate.

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What are the treatments for an enlarged prostate

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When it comes to treating benign prostatic hyperplasia or enlarged prostate, several options are available ranging from “watchful waiting” or medical therapy to minimally invasive therapies or surgery.

Watchful Waiting

  • Monitoring the condition without immediate intervention.

Medication

  • Alpha-blockers: Relax bladder and prostate muscles for easier urination.
  • 5-alpha reductase inhibitors: Prevent hormonal changes and shrink the prostate.

Surgical Procedures

  • Transurethral Resection of the Prostate (TURP): Removes inner prostate tissue.
  • Prostatic Urethral Lift: Lifts prostate tissue to improve urine flow.
  • Open Prostatectomy: Removes the prostate through an abdominal incision.