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Dr Sidney Yip Kam Hung - A Problem among Elderly Men
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The need to urinate frequently and a disturbed urine flow are problems brought about by a common prostate problem in elderly men. Appropriate treatment can help bring relief and improve quality of life.

 

Mr Cheung (anonym) could not remember when he first began to feel the need to urinate more frequently and began suffering from a weak urine flow. However, he did recall how he often felt urine was being retained in the bladder, even after he visited the toilet.

 

Like many elderly men, he tried to tolerate the situation and it was not until he began to experience complete failure of urination that he sought emergency help from his doctor. He was diagnosed with benign prostatic hyperplasia: a condition which causes the complete blockage of the urethra.


Interrupting the flow 

Prostatic hyperplasia is a natural phenomenon found among men aged forty or above and is often named “benign prostatic hyperplasia (BPH)” or simply “enlarged prostate”.

 

The condition is a benign, natural but ongoing process. However, due to the fact that the location of prostate is below the bladder and surrounds the urethra, the enlarged prostate may compress the urethra and impede the flow of urine.

 

The initial stage of enlarged prostate can cause minor symptoms such as frequent urination and nocturia, excessive urinating during the night. In more acute cases it leads to difficulty in urinating, blood in the urine or even complete failure of urination.

 

How TURP can help

In the case of Mr Cheung, the condition had become serious, resulting in damage to his kidneys. As a result, Mr Cheung was treated with a urinary catheter and doctors recommended he undergo surgery to remove the blocking prostate tissues.

 

Nowadays, transurethral resection of the prostate (TURP) is a common surgery for BHP. The surgery involves the insertion of an endoscope with a cutting metal core which is used to remove the blocking prostate tissue. The surgery relieves the blockage to the urethra and the tissue removed will be used for histological examination in order to detect the risks of other prostate diseases.

 

TURP is a minimally invasive surgical procedure which carries a low risk of bleeding due to the improved electric circuit design which allows the “cutting device” to remove the blocking prostate tissue and stop bleeding at the same time.

 

In general, the surgery takes only one or two hours and is carried out under spinal or general anesthesia. Patients usually need to stay in hospital for three to five days.

 

Quick recovery

In general, the condition of patients improves soon after surgery.

 

However, patients may experience pain and occasional bleeding in urination right after surgery which improves within two or three weeks.

 

Following the procedure, it is recommended that patients avoid excessive exercise and increase their consumption of dietary fibre to encourage normal bowel movements.

 

There is also a chance that prostate hyperplasia will recur and one in 10 patients may need to undergo additional intervention again years down the road. After the surgery, there is the chance of retrograde ejaculation in which semen enters the bladder. This can affect fertility but not the sex life.

 

The benefits of early diagnosis

Other than surgery, BPH can be treated with medicine or even with regular monitoring, depending on the condition of the patient and the level of disturbance it brings to his daily life.

 

Therefore, it is recommended that anyone experiencing urination problems seek help from their doctor as soon as possible.

 

Any delay may result in more serious complications such as urinary tract infections, bladder stones and damage to the bladder and kidney.

 

Your doctor will evaluate your condition and decide on the most appropriate treatment using a prostate symptom score sheet, a rectal examination, urine flow rate test, kidney function blood tests, testing of prostate specific antigen, and ultrasonic examination. 



Source: Dr Yip Kam Hung, Specialist in Urology at Hong Kong Adventist Hospital – Stubbs Road