Benign prostatic hyperplasia (BPH)

More than half of men over age 60 have an enlarged prostate. The possibility of growth of this gland increases over the years. Generally, this growth is not malignant and is called benign prostatic hyperplasia.

When the growth of the prostate gland interferes with the urinary flow, some symptoms may appear:

  • Weak urine stream
  • Feeling of incomplete evacuated bladder
  • Difficulty initiating urination
  • Frequent urination
  • Urgency or difficulty in holding urine
  • Waking up frequently at night to urinate
  • Intermittent urine stream

Surgical treatment:

Of all the treatment options, prostate surgery offers the best chance of improving symptoms. However, surgery also has the highest rates of significant complications.

The most common surgical procedure to relieve the symptoms of benign prostatic hypertrophy is transurethral resection of the prostate (TPR), in which the obstructive part of the prostate is removed. For this intervention it is not necessary to cut the skin since it is done through the urethra. It can also be performed with a laser and, like RTP, requires the introduction of an endoscope through the urethra.

In other cases, robotic surgery (DaVinci) or laparoscopic surgery is indicated, especially when the prostate is very large or there is a specific indication to choose that route. In this case it is necessary to make a small incision in the lower part of the abdomen. It has the advantage over laser surgery, which produces less urinary incontinence and less urethral stricture.

Although surgery reduces symptoms in most patients, it may not completely eliminate discomfort. For example, a weak bladder may continue to have urinary symptoms, even though the urinary obstruction has been removed.

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