What are the symptoms of Enlarged Prostate?

Enlarged Prostate (BPH) Treatment & Symptoms

Enlarged Prostate or Benign Prostatic Hyperplasia (BPH) is mistaken to be simply a case of too many prostate cells. But, in fact, there is no cure for BPH and once prostate growth starts, it often continues, unless medical therapy is started. The prostate gland grows in two different ways. In the first type of growth, the cells multiply around the urethra and squeeze it, much like you can squeeze a straw. The second type of growth is the middle-lobe prostate growth, in which the cells grow into the urethra and the bladder outlet area. This type of growth typically requires surgery.

Sign & Symptoms

Blood in the urine (i.e. hematuria), caused by straining to void

Dribbling after voiding

Feeling that the bladder has not emptied completely even after urination

Frequent urination, particularly at night (nocturia)

Hesitant, interrupted or weak urine stream caused by decreased force

Leakage of urine (overflow incontinence)

Pushing or straining to begin urination

Recurrent, sudden, urgent need to urinate

In severe cases of BPH, Acute Urinary Retention (inability to urinate) may result. It causes severe pain and discomfort. Catheterization may be necessary to drain urine from the bladder to obtain relief.

Diagnosis of Enlarged Prostate

Clinical symptoms and physical examination provide the basis for the diagnosis of Enlarged Prostate or Benign Prostatic Hyperplasia. The physical examination includes a digital rectal examination (DRE). Symptom evaluation is obtained from the results of the AUA Symptom Index.

Digital Rectal Examination (DRE)

DRE typically takes less than a minute to perform. The doctor inserts a lubricated, gloved finger into the patient’s rectum to feel the surface of the prostate gland through the rectal wall to assess its size, shape and consistency. Healthy prostate tissue is soft, like the fleshy tissue of the hand where the thumb joins the palm. Malignant tissue is firm, hard and often asymmetrical or stony like the bridge of the nose. If the examination reveals the presence of unhealthy tissue, additional tests are performed to determine the nature of the abnormality.

AUA Symptom Index

American Urological Association (AUA) Symptom Index is a questionnaire designed to determine the seriousness of a man’s urinary problems and to help diagnose BPH. The patient answers seven questions related to common symptoms of benign prostatic hyperplasia. How frequently the patient experiences each symptom is rated on a scale of 1 to 5. These numbers added together to provide a score that is used to evaluate the condition. An AUA score of 0 to 7 means the condition is mild; 8 to 19, moderate; and 20 to 35, severe.

PSA Test

A blood test to check the levels of prostate-specific antigen (PSA) in a patient who may have BPH helps the doctor to eliminate the diagnosis of prostate cancer.

Uroflowmetry Test

This is a simple test which records the urine flow to determine how quickly and completely the bladder can be emptied. With a full bladder, the patient urinates into a device that measures the amount of urine, the time is taken, and the rate of urine flow. Patients with stress or urge incontinence usually have a normal or increased urinary flow rate, unless there is an obstruction in the urinary tract. A reduced flow rate may indicate BPH.M

Post-Void Residual (PVR)

This test measures the amount of urine that remains in the bladder even after urination. The patient is asked to urinate immediately prior to the test and the residual urine is determined by ultrasound. PVR less than 50 ml. generally indicates adequate bladder emptying and measurements of 100 to 200 ml or higher often indicates a blockage.

Laser Enlarged Prostate (BPH) Treatment

Holmium Laser Enucleation of Prostate (HoLEP): It is the latest modality used in the management of Enlarged Prostate. In this procedure, a 550 Micron Fibre attached to a 100-Watts Holmium Laser machine is used to remove obstructive prostatic tissue and seal blood vessels. The enucleated gland is then pushed into the bladder, which is later sucked out with the help of equipment called Morcellator. The whole procedure takes around 45-90 minutes, depending on the size of the gland. This procedure is nearly bloodless as the laser beam when cuts the gland also seals the blood vessels. In most of the cases, there is no need for blood transfusion. At the end of the surgery, a catheter is inserted to keep the bladder in place. It continuously drains the urine into a sterile collection bag. The catheter is usually kept for 24 to 48 hrs and the patient is discharged without a catheter after giving a catheter-free trial.

What is Kidney Stone and how can it be cured ?

Urinary / Kidney Stone Treatment & Laser Stone Surgery

Hardened mineral deposits formed in the kidney are called urinary or kidney stones (calculi). These originate as microscopic particles and over the course of time develop into stones. Medically this condition is known as nephrolithiasis or renal stone disease. The kidneys filter waste products from the blood and add them to the urine. When waste materials in the urine do not dissolve completely and the kidney is unable to evacuate them, crystals and kidney stones are likely to form. Some stones may pass out of the kidney or get lodged in the ureter (the tube that carries urine from the kidney to the bladder) and cause severe pain that starts from the low back and radiates to the side or groin. A lodged stone can block the flow of urine and build a backpressure in the affected ureter and kidney. Increased pressure results in stretching and spasm causing severe pain

Sign & Symptoms of Kidney Stones

Small and smooth kidney stones may remain in the kidney or pass without causing pain (called “silent” stones). Stones that lodge in the ureter (the tube that carries urine from the kidneys to the bladder) cause spasm in the urinary system and produce pain. This pain is unrelated to the size of the stone.

Other symptoms of kidney stones may include the following:

Blood in the urine

Pain and burning during urination

Increased frequency of urination

Fever, chills, loss of appetite

Nausea and vomiting

Fever, chills, loss of appetite

Diagnosis of Kidney Stone

Complete Blood Count

Kidney Function Test

Urine Routine & Microscopy

Kidney Stone [Urinary Stone] Treatment

Extracorporeal Shock Wave Lithotripsy (ESWL) uses highly focused electromagnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stone is reduced to sand-like particles that can pass in the urine. Large stones may require more than one sessions. it can be used for patients of all age groups and those who have heart and breathing problems. However, the procedure is contraindicated for pregnant women. ESWL by 4th generation “SIEMENS LITHOTRIPTER” with ultrasound attachment helps to treat even radiolucent stones, which are not visible in normal fluoroscopy Lithotripters.

Percutaneous Nephrostolithotomy (PCNL) is performed under epidural or spinal anaesthesia. Percutaneous (through skin) removal of kidney stones (lithotomy) is accomplished through the most direct route. A telescope along with the mechanical lithotripter in inserted to break the stone into fine particles so as to achieve a stone-free status in large and complicated stones. This procedure usually requires hospitalization, and most patients resume normal activity within 2 weeks.

Ureterorenoscopy Lithotripsy with Holmium Laser is performed under epidural and spinal anaesthesia to treat stones located in the middle or lower ureter. A small, fibre-optic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watt Coherent Holmium Laser. The laser fragments the stone into the sand like particles, which are then flushed out through the natural urinary passage. The advantage of Holmium Laser is its ability to fragment stones of all compositions with precision. Thus, it is the most effective laser for the treatment of urinary stones. Patients are generally admitted on the same day of the treatment and are discharged the next day, which means only 24 hours of hospitalization is required.

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