The Wellington Hospital, London
Mr Amir Kaisary, Consultant Urologist at The Wellington Hospital, talks to us about enlarged prostates - the symptoms, the treatments and the latest options available to men, including Green Light Laser Therapy.
The prostate is an essential reproductive gland which supports and promotes male sperm function and fertility. Positioned just under the bladder, the urethra runs through the middle of the prostate. Issues arise when the prostate becomes enlarged, and the urethra becomes constricted, leading to a blockage.
Over the age of 40, all men have some enlargement of their prostate, but only one in ten will ever develop an obstruction which needs treatment. Size is irrelevant, as the smallest prostates may cause severe obstruction and the bigger glands none at all.
Common symptoms men may have include: frequent urination, weak urine flow, trouble starting and stopping the urinary stream and an inability to completely empty the bladder. Each patient is assessed as an individual and requires a careful history to be taken, and some of these questions will cover both blockage and irritative symptoms.
A clinical assessment by a doctor includes an abdominal palpation and a rectal examination.
These simple but valuable investigations include:
Flow rates can vary from day to day, and a poor flow may not necessarily mean there is an obstruction; it may result from a weak bladder.
Residual urine can be measured by abdominal ultrasound, and again this may vary from day to day.
In selected cases further evaluation of the prostate gland can be obtained via a dedicated ultrasound rectal examination, which assesses the character and volume of the prostate and may help in the management or treatment of the disease.
Not every patient necessarily needs intervention. Those with mild symptoms and no abnormal examination findings may only need to be watched and reviewed regularly.