Enlargement of prostate occurs in majority of males above the age of 50 years. The enlargement goes on increasing as the age advances. It is an age related disease. All patients with enlargement of prostate do not require treatment. Only patients who hace complaints attributable to it require treatment.
Usually initial treatment consists of medical line of management. But in presence of severe enlargement or in presence of symptoms of complications of enlargement, patient may be advised surgical treatment soon or at index presentation. This clinical decision is best left for the Urologist who is treating the patient.
Symptoms of prostate enlargement include the following:
Hesitancy : Urinary stream does not start soon after reaching toilet. It takes finite time and patient has to wait for the stream to start.
Poor Stream: Even after the stream starts, it is poor in caliber and flow.
Time taken to complete urination takes progressively longer and longer.
Feeling of incomplete evacuation of urinary bladder, at the end of urination.
Frequency of urination. Duration of less than 2 hours, between urination
Nocturia: waking up more than 1-2 times at night to pass urine.
Urgency: the warning period once patient feels the urge to pass urine, till he actually can pass urine gets lesser and lesser.
Urge Incontinence: Urgency may precipitate leakage of urine before one can reach toilet.
Bothersome effect of these complaints: due to lack of sleep or too much frequency of urination, patient lifestyle gets affected.
In cases with severe enlargement or complications of enlargement of prostate, patients may have following additional symptoms:
- Recurrent urinary tract infection
- Recurrent bleeding in urine
- Fever with chills
- Acute retention of urine
Retaining progressively larger quantity of urine in the bladder even after passing urination. This may lead to chronic retention of urine with overflow incontinence.
- Presence of Urinary Bladder Calculi
- Backpressure changes in the bladder and upper tracts
- Kidney dysfunction or azotemia