When it comes to their own health, men are often somewhat hesitant. Nevertheless, after a certain age it is important to deal with the topic of "benign prostate enlargement".
Many men are affected by benign prostate enlargement as they age. Therefore, it is helpful to know signs and symptoms of benign prostate enlargement. We would be happy to inform you about the various diagnosis and treatment options for benign prostate enlargement. At our center, we specialize in the diagnosis and treatment of benign prostate enlargement. Together with our patients, we can identify ways to prevent potential benign prostate enlargement problems or improve existing symptoms.
Benign prostate enlargement, also known as benign prostatic hyperplasia (BPH), is a common condition that affects many men. It is a benign change in the prostate gland, the exact causes of which are not yet fully understood. Typical symptoms of benign prostate enlargement are frequent urination, urine leakage and urination at night. Difficulty in starting to urinate, weak urine stream and interruptions in the flow of urine are further signs. Unpleasant complications of benign prostate enlargement include acute, painful urinary retention ("nothing works") or recurrent urinary tract infections (e.g. cystitis, prostatitis). The diagnosis of benign prostate enlargement is made by a specialist in urology. They perform a physical examination as well as specific tests such as urine tests and an ultrasound. Another important diagnostic measure is the measurement of urine flow by means of uroflowmetry, a special device for measuring urine flow. Timely treatment can help stop the progression of benign prostate enlargement and relieve symptoms.
Definition of benign prostate enlargement
Benign prostatic hyperplasia is an excessive growth of prostate tissue. In technical terminology, benign prostate enlargement is also referred to as benign prostatic hyperplasia (BPH). This benign disease often occurs in men of advanced age.
Our experts on the topic of prostate enlargement
"In early stages, benign prostate enlargement often causes no noticeable symptoms. That's why it's important to have regular screenings to detect changes early."
What causes benign prostate enlargement?
The exact causes of benign prostate enlargement are not yet fully understood. It is suspected that various factors contribute. However, male sex hormones (androgens) appear to play a key role. In addition to hormones, other factors such as inflammation, genetics, atherosclerosis, microorganisms, lifestyle, concomitant diseases and age also influence the development of benign prostate enlargement.
Increasing age
A major factor in the development of benign prostate enlargement is age. With increasing age, the risk of developing benign prostate enlargement increases. From the age of 40, the prostate may gradually increase in size. Over time, this can lead to discomfort.
Testosterone
Another factor that may play a role is the sex hormone testosterone. The conversion of testosterone to the more potent dihydrotestosterone (DHT) in the prostate can stimulate prostate growth. An imbalance between testosterone and DHT can lead to excessive cell division in the prostate, contributing to benign enlargement of the prostate.
Genetic factors
Genetic factors tend to play a minor role in benign prostate enlargement. The likelihood of a genetic component as the cause of benign prostate enlargement is higher if the prostate enlargement becomes clinically relevant at a relatively young age.
Symptoms and signs of benign prostate enlargement
Symptoms of benign prostatic hyperplasia (BPH) can be many and vary from patient to patient. The first signs often include a delayed onset of urination and a weak urinary stream. Frequent urination is another typical symptom of this condition. Affected men have to go to the toilet more often, especially at night. Due to the weak urine stream, it is often difficult to empty the bladder completely. It is not uncommon for residual urine to remain in the urinary tract after urination and to "dribble" later.
Frequent urination
Strong urge to urinate
Nightly urination
Weak urine stream
Urine dribbling
Benign prostate enlargement can lead to various complications, including urinary retention, bleeding and infection, bladder stones, and kidney congestion. Urinary retention occurs when urination is no longer possible. This condition is extremely painful and requires immediate medical attention. Bladder stones can block the flow of urine from the bladder and cause irritation. Kidney congestion occurs when urine cannot flow properly, usually permanently, and accumulates in the kidneys. It is important to recognize these complications early and treat them appropriately.
At alta uro, the treatment of benign prostate enlargement is one of our main focuses.
Diagnosis and examination methods
Physical examination
Urine and blood tests
Imaging techniques
Treatment options for benign prostate enlargement
There are various treatment approaches available for the treatment of benign prostate enlargement. The choice of the right treatment option depends on individual factors and should be discussed with your specialist. The patient's symptoms are the primary consideration in treatment. If the symptoms are minor, an adjustment of lifestyle such as drinking behavior is often sufficient. If the symptoms are not very troublesome and the examination carried out does not reveal any evidence of serious damage, treatment with medication is possible. In the meantime, various preparations are available which can also be individually combined depending on the size of the prostate and the symptoms.
Drug therapy
Alpha Blocker
The most commonly prescribed group of drugs for the treatment of benign prostate enlargement. Alpha-blockers are characterized by a rapid onset of action.
PDE-5 inhibitors
Originally developed for the treatment of erectile dysfunction, one active ingredient in this group (tadalafil) is also approved for the treatment of urinary symptoms. This preparation is particularly suitable when accompanied by erectile dysfunction.
5-alpha-reductase inhibitors
In contrast to other drug groups, these preparations can slow down the growth of the prostate and the progression of symptoms. However, the onset of action is delayed.
Herbal preparations
Herbal preparations are also available as an alternative to synthetic preparations. The low spectrum of side effects should be emphasized.
Antimuscarinic
Antimuscarinics are part of the standard therapy for overactive bladder. This results in a reduction of involuntary bladder contractions, less urge to urinate and increased bladder volume.
Beta-3 agonist mirabegron
Mirabegron is a drug used to treat overactive bladder. Recent data show benefit in the treatment of increased urination and frequent urination in patients with benign prostatic enlargement.
Combination therapies
Combining alpha-blockers with 5-alpha-reductase inhibitors can provide rapid improvement in symptoms while achieving long-term reduction in prostate size. In patients in whom single therapy has not provided sufficient improvement, the combination of alpha-blockers with antimuscarinics may be effective.
If medication does not respond satisfactorily or if there is serious damage to the urinary tract, surgical therapy should be considered.
At alta uro, affected men have a comprehensive choice of minimally invasive and innovative surgical procedures for the treatment of benign prostate enlargement. The choice of surgical procedure is an individual decision. Therefore, we take a lot of time to know the wishes and expectations of our patients. When deciding on a surgical therapy, we place great emphasis on ensuring that the chosen procedure meets the needs and preferences of each individual patient.
The choice of surgical treatment for alta uro
In order to be able to select the most suitable procedure for our patients, the individual situation as well as the preferences and expectations of our patients are included in the decision. Together, we select the ideal procedure. The following aspects are taken into consideration for this:
Extensiveness of the complaints and restriction of the quality of life
The size of the prostatewhich is determined by ultrasound
Co-existing and pre-existing conditions or the use of medications
TAH: Antiplatelet agents I OAK: Oral anticoagulants I NOAK: New oral anticoagulants
Bipolar TUR-Prostate (TUR-P)
- the "classic" prostate resection, performed with modern technology The operation is performed via the urethra and requires spinal or general anesthesia. The prostate tissue is removed through an endoscope by means of a snare through which an electric current flows. The prostate tissue that interferes with bladder emptying is removed so that the bladder can then be emptied again without obstruction.
For whom is the procedure suitable?
TUR-Prostata or TUR-P for short is still one of the standard procedures for patients with a prostate volume up to about 100 ml. The procedure is very well established and the technique has been further developed in recent years. Alta uro performs the operation exclusively with a so-called bipolar resection instrument, so that the risk of bleeding is minimized. Furthermore, the so-called wash-in syndrome, a sometimes life-threatening change in the salt content of the blood, can be prevented, since the irrigation solution has a salt content identical to that of the blood.
What are the advantages of this procedure?
The advantage of bipolar TUR prostate is that it is one of the most established surgical procedures in urology. There are numerous studies on the long-term effect of the technique as well as on its safety.
What are the known risks and disadvantages?
Any procedure in which tissue of the prostate is removed is associated with a certain risk of bleeding. In addition, there is often a failure to ejaculate. There is also a small risk of narrowing of the urethra in response to the surgery. Furthermore, the ablated tissue can grow back, so in rare cases, surgery may be necessary again after a certain period of time. The risk of involuntary loss of urine (incontinence) after surgery is very low.
Greenlight laser vaporization of the prostate
- a particularly gentle and safe surgical procedure Greenlight laser vaporization is a proven technique for treating benign prostate enlargement. Performed through the urethra under anesthesia, the procedure uses high-power laser technology to quickly and precisely vaporize the enlarged prostate tissue. When the surgeon directs the laser beam to the prostate, pulses of light from the laser are absorbed by the prostate tissue. Within milliseconds, the temperature of the water in the tissue becomes so high that the tissue vaporizes ... learn more
For whom is the procedure suitable?
What are the advantages of this procedure?
What are the known risks and disadvantages?
Aquablation
- the first robotic surgical procedure for benign prostate enlargement. Ideal for patients for whom sparing ejaculation is important The AquaBeam system represents a novelty for the treatment of benign prostate enlargement. Here, a computer-controlled water jet is used to remove the excess prostate tissue. This procedure is also performed endoscopically through the urethra under anesthesia. No electric current or heat is used to remove the tissue and the surrounding tissue is optimally protected ... learn more
For whom is the procedure suitable?
In principle, prostate aquablation is suitable for patients with medium to large prostate volumes. Anticoagulants should not be taken.
What are the advantages of this procedure?
The procedure has been scientifically investigated in various studies and compared, among others, with the results of TUR prostate. In particular, a high rate of patients in whom ejaculation and sexual function are preserved is shown with comparable improvement in urination with aquablation.
Maximum precision is ensured by the surgical robot, which ablates the area previously defined by the surgeon using ultrasound. The precision, the relatively restrained ablation of the tissue and the absence of heat are reasons why ejaculation can be preserved in many cases.
What are the known risks and disadvantages?
Aquablation is a new type of surgical procedure. Therefore, long-term data of more than five years from comparative studies to TUR prostate are currently still missing. The occurrence of postoperative bleeding is also possible after aquablation, but is low due to the endoscopic control and hemostasis routinely performed during surgery. The risk of involuntary urine leakage is very low after aquablation.
Adenoma enucleation with the Da Vinci surgical robot
- especially for patients with very large prostate If there is a very pronounced enlargement of the prostate, surgery can be performed using the Da Vinci robot. For this purpose, the instruments of the surgical robot are used to open the urinary bladder through small incisions on the abdomen and then the benign tissue of the prostate is removed ... learn more
For whom is the procedure suitable?
What are the advantages of this procedure?
What are the known risks and disadvantages?
Rezum
- a minimally invasive procedure for patients who do not wish their sexuality to be impaired In this minimally invasive therapy, sterile steam is injected into the prostate tissue to be treated under endoscopic control. The inner zone of the prostate is treated, which causes the enlargement of the prostate and thus the symptoms. Through contact with the tissue, the water vapor returns to its liquid state, releasing the stored heat. The released heat damages and breaks down the cells in the treatment area. This causes the prostate to shrink, clearing the way for urine flow after a few weeks. After treatment, patients are given a urinary catheter, which can be removed after a few days ... learn more
For whom is the procedure suitable?
The procedure is particularly suitable for patients with small and medium prostate volume up to approx. 80 ml. Since no tissue is removed, the procedure is also possible under local anesthesia or sedation. Spinal or general anesthesia is therefore not necessarily required. Due to the fact that in most cases the ejaculation can be spared as well as the minimal invasiveness, the procedure is also suitable for younger patients. The procedure offers a middle ground between medication and tissue-ablative procedures.
What are the advantages of this procedure?
Since there is no spread of heat beyond the prostate, incontinence is virtually excluded. Ejaculation is also almost unaffected. In addition, it is a very short procedure, which in most cases takes no longer than 10 - 15 minutes. Since no tissue is removed, the risk of post-operative bleeding or impairment due to wound healing is also minimal.
What are the known risks and disadvantages?
Long-term efficacy data over 5 years are now available for Rezum. These data show that the rate of patients requiring a second operation is about 5%. The number of patients who need medication again is about 10%. In contrast to other techniques, the effect of the operation is not immediate, so that in some cases an improvement is only noticed after a few weeks. In addition, a transurethral catheter is required for a few days after the operation.
Prevention, prevention and prevention
Regular preventive medical checkups
Exercise and physical activity
Nutrition and hydration
FAQs
Who does benign prostate enlargement affect?
Benign prostate enlargement affects almost every man with increasing age. However, the severity of the symptoms varies greatly.
What are the symptoms of benign prostate enlargement?
The complaints can be varied. A delayed start to urination, a weak urine stream, pressing when urinating or the feeling of incomplete emptying of the bladder are typical complaints. In addition, there is often nocturnal urination, an increased urge to urinate or dribbling of urine.
How does benign prostate enlargement develop?
The exact mechanisms of the development of benign prostate enlargement are still unclear. It is assumed that there is a combination of hormonal changes and chronic inflammation. This causes the cells of the prostate to multiply and enlarge.
How is benign prostate enlargement diagnosed?
A conversation with the affected person provides clues. A measurement of the urine stream, a urine examination and an ultrasound examination of the urinary bladder, prostate and kidneys then lead to the diagnosis.
Is benign prostate enlargement dangerous?
Benign prostate enlargement is not a precursor to cancer. Although the symptoms are often disturbing, they are almost never dangerous. Only rarely can more serious impairment of kidney function or dangerous urinary tract infections occur due to damage to the urinary tract.
How to treat benign prostate enlargement?
Very important: Enlargement alone does not mean that treatment is necessary. Treatment is only necessary if disturbing complaints exist. Depending on the symptoms and the findings, the spectrum ranges from lifestyle changes to medication and surgery.
What treatments does alta uro offer for benign prostate enlargement?
The individual complaints of the patient are in the foreground of the treatment. If the symptoms are not very disturbing and no serious findings are found in the urological examination, therapy with medication is possible. Nowadays, various preparations are available, which can also be combined individually depending on the size of the prostate and the symptoms.
If medication does not respond satisfactorily or if there is repeated urinary retention, surgery is required. Here, alta uro offers a wide range of minimally invasive and innovative therapies. The choice of procedure is adapted to the individual circumstances and wishes of our patients.
Member of the Swiss Society of Urology Member of the Quality Register of the Swiss Society of Urology Certified cooperation partner of the German Cancer Society Certified medical advice center of the German Continence Society
