Enlarged Prostate (BPH)
Benign prostatic hypertrophy is a non-cancerous condition where there is an excess of glandular prostatic tissue, related to a genetic pre-disposition and a possibly hormonal and/or inflammatory state. The excess glandular tissue causes prostatic urethral closure and obstruction to urinary bladder drainage.
Patients present with a prolonged voiding time with flow reduction and terminal dribble, or difficulty initiating the stream. Sometimes there is frequency or increased night time voiding.
Some patients retain urine in the bladder and may have urinary infections or bladder stones. There are tablets used to either open the prostatic smooth muscle to improve the flow rate or to shrink the prostate over several years.
Surgical options include the traditional bore out procedure, TURP, (transurethral resection of the prostate), which can be done using a bipolar normal saline irrigation system, taking under an hour.
TURP shaves through the middle of the prostate and opens the passageway and channel, in order to allow complete urinary drainage and improve both the flow rate and voiding times. This usually requires one or two inpatient nights in hospital.
There are laser techniques to vapourise the tissue as an alternative, although this method does not allow for retrieval of prostate tissue for analysis, as occurs in traditional TURP.
The assessment of any male patient with urinary flow problems is undertaken very carefully with a history, physical examination, blood and urine tests, ultrasound and in the main suite at Norwest Private Hospital, both urinary flow studies or formal urodynamic studies, prior to embarking on either medical or surgical treatment.