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75yr old. Has inguinal hernia. Found enlarged prostate. Suggested prostate surgery. Some say not required. Opinion?

good evening Dr. Chandan, My father, now aged 75 years. he has inguinal hernia (right side , approx 14 years) and we are planning for surgery though there is no pain or emergency. But the surgeon found enlarged prostate(enlarged prostate 36 gms with significant post void residual volume & mild cystitis , no focal lesion seen) in clinical examination, and he now advises for surgery for prostate(TRUP Method) too - because he says that hernia problem will reappear soon if prostate problem is not treated now. some doctors advised me their are no need to oprate prostate because it size is too small & no urine blockage problem , Will be treated by medicine . I will be highly obliged if you kindly advise me. Regards, Ritesh Gupta email - YYYY@YYYY
Asked On : Fri, 22 Mar 2013
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General & Family Physician 's  Response
Hello and welcome to HCM.

Thank you for your query.

Before even considering the size of your father's prostate, we will almost always have to consider a conservative method of management. This will include medication. Your father's prostate is indeed not that large, and unless it is producing significant amount of trouble, it should be treated conservatively. This will include alpha blockers and 5 alpha reductase inhibitors.

Only if the medication is not effective in reducing the size of the prostate or if the enlarged prostate is causing some amount of discomfort should surgery be considered. TURP is indeed the best option if surgery has to be considered.

The medications should start taking effect soon, and will show results within 2-3 months. As mentioned by you, hernia is not an emergency, and thus, I don't see why your doctor cannot wait for a while if he considers the prostate to be a problem.

I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications. I would gladly help you.

Best wishes.
Answered: Fri, 22 Mar 2013
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