What is BPH (Benign prostatic hyperplasia) ?
Benign prostatic hyperplasia (BPH) in simple terms means non-cancerous enlargement of the prostate gland.
Benign prostatic hyperplasia (BPH), also known as prostate gland enlargement, is a common condition affecting older men.
It occurs when the prostate gland grows in size and begins to exert pressure on the urethra, causing urinary symptoms. Timely diagnosis and appropriate treatment are crucial in managing BPH effectively.
If you are in Mumbai and seeking effective BPH treatment, Dr. Amit Sahu is a renowned urologist with expertise in managing this condition.
Here, we will explore the available BPH treatment in Mumbai, with a special focus on Dr. Amit Sahu professional services.
FACT CHECK: It is the most common benign tumor found in men.
What are Signs & Symptoms of BPH?
BPH produces symptoms by obstructing the flow of urine through the urethra. Symptoms related to BPH are present in about one in four men by age 55 & may progressively increase with age.
Symptoms can be divided into those caused directly by urethral obstruction and those due to secondary changes in the bladder.
Typical obstructive symptoms are:
- Difficulty starting to urinate despite lot of pushing and straining
- A weak stream of urine; several interruptions in the stream
- Dribbling at the end of urination
Bladder changes cause:
- A sudden strong desire to urinate (urgency)
- Frequent urination
- The sensation that the bladder is not empty after urination is completed
- Frequent awakening at night to urinate (nocturia)
- As the bladder becomes more sensitive to retained urine, men may become incontinent (unable to control the bladder, causing bed wetting at night or inability to respond quickly enough to urinary urgency).
- Burning or pain during urination can occur if a bladder tumor, infection or stone is present.
How to Screen and Diagnose BPH?
Various Clinical, Lab & Imaging tests are performed to confirm BPH:
- Physical Examination with Direct Examination to check enlargement, consistency of prostate
- Urinalysis, Uroflowmetry
- Measuring prostate specific antigen (PSA) levels in the blood
- Ultrasonography to check for size of prostate, amount of urinary retention & changes in urinary bladder. MRI may also be performed to study prostate gland in detail.
When is BPH treatment necessary?
Treatment is usually necessary if symptoms become bothersome.
The course of BPH in is not predictable. Symptoms can remain stable for many years and may even improve over time for as many as one-third of men, according to some studies.
If worsening urethral obstruction is left untreated, possible complications like a thickened, irritable bladder with reduced capacity for urine; infection of residual urine, bladder stones and a back pressure changes with damage on kidneys may develop.
Decisions regarding treatment are based on the severity of symptoms, the extent of urinary tract damage and the man’s overall health. Each individual must determine whether the symptoms interfere with his life enough to merit treatment.
What are treatment options for Enlarged Prostate , BPH?
- Medications to help shrink prostate & relax prostate muscle tissue.
- Surgery
- Prostatic artery embolization
Surgery was the only option until the recent approval & demonstrable benefit of minimally invasive interventional procedure.
What is a Prostatic Artery Embolization?
Prostatic artery embolization (PAE) is a minimally invasive interventional treatment that helps improve lower urinary tract symptoms caused by a Benign Prostatic Hyperplasia (BPH). The PAE procedure is performed by an interventional radiologist (IR), a doctor who uses X-rays and other advanced imaging to see inside the body and treat conditions without surgery.
Why have Prostatic Artery Embolization?
As the prostate gets bigger, it may constrict or partly block the urethra, causing lower urinary tract symptoms such as:
- Urinary incontinence, which can range from some leaking to complete loss of bladder control
- Irritative voiding symptoms
- Increased urinary frequency, urgency, and pain upon urination
Is Prostatic Artery Embolization right for you?
The PAE procedure is for candidates who are either ineligible or not interested in traditional surgery. An examination with an Interventional Radiologist can determine if you are a candidate for PAE.
What happens during Prostatic Artery Embolization?
- An Interventional Radiologist (IR) performs PAE in a CathLab using angiography techniques.
- A Foley’s catheter may be inserted into your urethra and positioned in your bladder before PAE.
- PAE is performed through a small catheter inserted by your Interventional Radiologist into the artery in your wrist or groin. The catheter is then advanced into the vessels that supply blood to your prostate.
- Angiography is done to map the blood vessels feeding your prostate.
- Tiny particles are injected into the blood vessels that feed your prostate to reduce its blood supply.
- After this procedure the prostate will begin to shrink, relieving and improving symptoms usually within days of the procedure.
What are the risks of Prostatic Artery Embolization?
PAE should only be performed by knowledgeable and trained interventional radiologists. Patients may experience “post-PAE syndrome” for days following the procedure, which can include nausea, vomiting, fever, pelvic pain, or painful or frequent urination.
Other minor risks include hematoma at the incision site, dysuria (9%), blood in the urine (5-6%), semen, or stool (2.5%) ; bladder spasm, infection in urinary tract (7.6%).
What are other options to treat BPH ?
Other than PAE, two other surgical options are available for BPH:
UroLift
It involves using small implants to help left prostate away from urethra. It is usually recommended for small prostate glands & is not effective in larger sized prostates and may not be suitable for all types of prostate enlargements.
Trans Urethral Resection of Prostate (TURP)
It is one of the commonest surgery for prostate. It may require longer hospital admission and may have a dowtime upto even few months.
Patients may experience few side effects from surgery like:
- Post-operative bleeding in urine
- Temporary difficulty with passing urine
- Sexual side effects like impotence, retrograde ejaculation, sexual dysfunction
What are advantages of PAE in comparison to surgery?
- PAE being a non-surgical procedure requires less hospital stay (average 1-2 days)
- PAE can even be safely performed in patients having high surgical risk factors
- PAE has lower risk of complications, sexual side-effects compared to surgery
- PAE has overall reduced side effects and lesser down time
- PAE is equally effective as any other surgical procedure for BPH
Conclusion:
For individuals in Mumbai seeking effective BPH treatment, Dr. Amit Sahu is a highly experienced Interventional Radiologist offering a comprehensive range of treatment options. From medications to minimally invasive procedures and surgical interventions, Dr. Amit Sahu expertise ensures personalized and optimal care for patients with BPH.
If you are experiencing urinary symptoms associated with an enlarged prostate gland, consult Dr. Amit Sahu to discuss the most suitable treatment plan tailored to your specific needs.