Benign prostatic hyperplasia (BPH), or enlarged prostate, is a common urological condition among men over 50, caused by the non-cancerous enlargement of the prostate gland.
The main function of the prostate is related to the production of fluids that accompany semen during ejaculation. The prostate lies between the bladder and the penis. As men get older, the number of prostate cells increases, causing the prostate gland to enlarge, squeezing down on the urethra. This can result in:
BPH usually leads to symptoms that affect urination, such as:
Consult your urologist if you are experiencing any of these symptoms. Your doctor will perform tests to rule out prostate cancer and confirm a benign diagnosis. If the BPH condition is left ignored for a long period of time, patients are likely to develop the inability to pass urine (acute urinary retention), bladder stones, recurrent urinary infections, and eventually obstructive kidney damage.
An enlarged prostate can be caused by:
Prostate enlargement is diagnosed by:
During the early phases of the condition, urologists keep a watchful eye on an enlarged prostate with periodic examinations and screenings. Once symptoms have progressed and become bothersome to the patient, treatments include drug therapy, minimally invasive procedures, and surgery.
Early BPH symptoms can be well controlled with medications known as alpha-blockers, which act on receptors in the bladder neck to relax the bladder outlet during urination. When symptoms are not improving with medications, the following treatment options are recommended:
Minimally invasive methods are usually performed as day procedures and do not require full general anaesthesia. They aim to provide relief of symptoms while minimising the risk of urinary incontinence and sexual dysfunction. These include treatments like Urolift, BPH Water Vapour Therapy, and Prolieve.
Dr Colin Teo is the Founding Head of Khoo Teck Puat Hospital’s Urology Department, with years of experience in minimally invasive keyhole surgery*, operating with precision surgical techniques. Many fellows have trained under his mentorship. He did a Fellowship in EndoLaparoscopy and Andrology at St James’ Hospital in Leeds, UK, and was sponsored for a Senior Healthcare Medical Development Program (HMDP) in Advanced Laparoscopic and Robotic Surgery at University of Southern California (USC) Keck Hospital in Los Angeles, USA.
Dr Teo was a co-author in the Urological Association of Asia BPH Consensus Committee and was involved in the Singapore Urological Association BPH Guidelines and the Society for Men’s Health Better Prostate Health Guidelines committee. He piloted and published the ePOD (early post-operative discharge) Prostate Bipolar Surgery Study that translated bipolar prostate surgery technology to shorter hospitalisation and catheter dependence in peer-reviewed journals that have since changed the clinical practice in his department and was invited for presentations for his BPH work in regional and international conferences.
*Robotic surgery refers to the use of a robotic surgical platform known as the da Vinci® Surgical System to perform minimally invasive surgery through small incisions. This innovative technology comprises a surgical cart that is docked next to the operating table to small ports placed through incisions <1cm in the patient’s abdomen. Robotic wristed instruments are then passed through these small ports into the abdomen, which are controlled by the surgeon sitting at the operating console some distance away from the operating table. A binocular camera lens affords the surgeon a 3-dimensional view of the operating field, which can be magnified up to 12 times. The surgeon then manipulates the camera lens and the various robotic instruments at the console using the hand controls and pedals. These specially designed instruments afford the surgeon excellent precision and dexterity of surgical movement because of their patented robotic wrist technology.
Seek recommendations on suitable treatment options for Benign Prostatic Hyperplasia (BPH) with Colin Teo Urology. Contact us to book an appointment today.