I am Dr. Piyush Singhania Professor of Urology. Today I would like to talk about benign enlargement of Prostrate gland. So very commonly we hear about patients suffering from prostate gland enlargement. Mostly it occurs in patients in men who are more than 50 years old. Now prostate gland is actually a small walnut-sized gland which is located just below the urinary bladder. So if we see this model this is the urinary bladder here which stores the urine which is produced by the kidneys from higher up. Now this is the white colored structure that you can see is the prostate gland and the pipe urethra through which we pass urine passes through the center of the prostate gland. So we can see in this picture very clearly so this is the urinary bladder which stores the urine and the urine comes out through a pipe called urethra and this urethra passes through the center of the prostate gland.
Now after 50 years of age normally the prostate gland starts enlarging in men. Now the reasons are not clearly known but it may be because of the change in the hormonal milieu of the body which causes its enlargement. Now as the prostate gland enlarges it presses on the pipe urethra and therefore the patient start having urinary symptoms. So they start having difficulty in passing urine. So now what is the function of the prostate gland? So normally the function of the prostate gland is that it produces a fluid which forms part of the semen which carries sperms. Now once the prostate gland enlarges that mostly occurs after 50 years of age in men the men start having difficulty in passing urine. Like they have difficulty to initiate the urination.
Sometimes they have the intermittency the urine stops and starts the stream becomes poor. Sometimes they have to wake up more than 2 times 3 times 4 times in the night to pass urine. Whenever they feel the urgency to pass urine they can't control it so there is severe urgency to pass urine even during the day time. Now all these problems can be tackled both by medicines and in some cases, surgical options have to. So if left untreated prostate gland enlargement can have complications so patients can develop stones in the urinary bladder they can get urinary tract infections they can start to have passing blood in urine sometimes the bladder is not able to empty itself completely because of the obstruction by the prostate gland. This can lead to post void residual urine. If left for a long time it can damage the bladder and if ignored further it can even have back pressure changes on the kidneys and damage to the kidney functions. Therefore we should not ignore the symptoms of prostate enlargement. Patients more than 50 years who have got urinary difficulties should immediately come for consultation and take the proper treatment. Now how do we treat benign enlargement of the prostate gland?
So before initiating the treatment, we do a complete physical examination of the patient we examine the prostate gland by erectile examination do certain tests like urine test uroflowmetry that is the speed of the urine and sonography ultrasound of abdomen and pelvis. Now after seeing the kidney functions and all these tests we decide on the further course of treatment which in most cases nowadays is with medicines because we have got very good alpha blockers and most of the patients are treated with tablet at night & nothing else. Very few patients who have got a huge enlargement of the prostate gland or whose prostate glands are not responding to the medicines are given the option of surgery. Even if the patient requires the surgical treatment it is minimally invasive. It does not require any cut or stitches. An endoscopy is passed through the normal urinary pipe that is the urethra and the prostate gland is removed from there. So there is nothing to worry & fear. Patients who are having prostatic symptoms should consult their urologist at the earliest get themselves evaluated and treated.
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