The prostate is a walnut-sized organ that forms part of the male reproductive system. It sits at the front of the bladder and above the rectum, and is responsible for producing the fluid that nourishes sperm during ejaculation. The urethra, through which urine travels from the bladder to the penis, runs through the prostate.
Due to factors such as family history, lifestyle, diet and hormonal changes, the prostate may start to grow in size, usually in men after the age of 30. As it enlarges over time, it presses against the urethra and blocks the flow of urine. This condition is known as benign prostatic hyperplasia, or an enlarged prostate.
Enlarged prostates are not all the same size. The size can be estimated during a digital rectal examination, and the doctor may also suggest an imaging test, such as an ultrasound, to assess it. A prostate of around 80 grams is considered very enlarged, but even a smaller enlargement should not be overlooked, and you should seek the best treatment to avoid further health complications.
When an enlarged prostate is left untreated, it may cause further blockage of the urethra, leading to worsening symptoms such as urinary tract infections, bladder stones, blood in the urine and kidney damage. Depending on your symptoms and other factors, the doctor will recommend the most suitable treatment options.
Modern Treatments for an Enlarged Prostate
Medical science is advancing rapidly. Today, open surgery is increasingly being replaced by minimally invasive procedures and alternative therapies that not only treat the condition but also ensure a quicker recovery and an improved quality of life. Here are some of the modern treatment options for an enlarged prostate that a doctor might suggest.
Water Vapour Thermal Therapy
Water vapour thermal therapy, or WVTT, uses a special steam-generating device to reduce the size of the prostate. Hot steam travels through a thin tube in the urethra and damages excess prostate tissue, which the body then gradually reabsorbs. After treatment, the size of the prostate decreases and less pressure is placed on the urethra.
This treatment can improve the symptoms of an enlarged prostate by around 54%. For someone experiencing moderate to severe symptoms, the doctor may suggest this therapy for relief. One of its main benefits is that it has only minor side effects.
Prostatic Urethral Lift
The prostatic urethral lift, also known as UroLift, uses implants to hold the prostate back and reduce pressure on the urethra. The procedure is performed by inserting a device into the urethra, which places tiny stainless-steel implants onto the prostate. Once secured, these move the prostate tissue away from the urethra, relieving the obstruction.
Doctors recommend this procedure in many cases due to its effectiveness and high success rate. While UroLift is a popular option for an enlarged prostate, it may not be suitable for everyone.
Transurethral Resection of the Prostate
During this procedure, the surgeon uses a small camera to look into the urethra and removes tissue to open up the channel, helping urine flow more freely and relieving pressure on the bladder. The tissue is removed using bipolar energy that shaves away pieces of the prostate.
TURP is regarded as an effective and less invasive procedure than open surgery. That said, it may lead to some side effects, such as infection, bleeding, the need for repeat resection, scarring and erectile dysfunction.
Transurethral Laser Ablation of the Prostate
Another modern treatment for an enlarged prostate is transurethral laser ablation of the prostate, also known as HoLAP. This procedure opens up the urinary channel using a high-powered holmium laser to vaporise excess prostate tissue. Similar to TURP, it helps improve urine flow and relieve the symptoms of an enlarged prostate. To read more about laser-based options, see our overview of laser prostate surgery.
The use of a laser reduces the need for a catheter and lowers the risk of bleeding and infection after the procedure. Doctors use a high-powered laser with Moses-effect pulses, as these remove tissue more efficiently and reduce the length of the procedure.
Prostate Artery Embolisation
Prostate artery embolisation, or PAE, is performed to restrict blood flow to the prostate, causing it to shrink. During the procedure, the doctor inserts a thin tube into an artery in the wrist or groin. Using imaging technology, they guide the tube into the prostate arteries and inject tiny round particles to restrict the blood flow.
While it is a suitable procedure for many patients, some research suggests that the symptoms of an enlarged prostate may recur even after treatment, and there may be complications. The findings on this procedure are mixed.
Takeaway
An enlarged prostate is a common problem in men. If you find yourself waking during the night or notice changes in your pattern of urination, discuss these symptoms with your doctor. Depending on your individual case, they will recommend the most suitable treatment option. For a fuller picture of the condition, you may also find our guide to the symptoms, causes and latest treatment options for an enlarged prostate helpful.
Every treatment plan starts with a proper assessment, so you only get the care your condition actually needs. If you have symptoms or a question about your health, book a consultation with Dr. Anish Gupta.