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Suggest treatment for prostatomegaly

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Posted on Tue, 21 Apr 2015
Question: My father is being treated with medicines (Silodol-8 mg and Dutas 0.5 mg) for the past 4-5 years for his BPH condition. His latest USG KUB impressions suggests:
(1) Mild Urinary bladder wall thickness.
(2) Prostatomegaly with post void residual urine of 58ml.
Prostrate volume is 39.1 cc.
Father is diabetic and a heart patient (acute ischemic heart disease- 1 stenting). Need suggestion regarding further course of treatment for BPH condition... Should he go for an operation now?
Symptoms- Need for urination every 1-1.5 hours, At night 2-3 times XXXXXXX no blood in urine/irritation etc.
doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
Surgery is the better option.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your father has obstructive voiding symptoms due to enlarged prostate which is common at this age.

The Silodosin and Dutasteride that he is taking will help to relieve his symptoms to some extent but he has to continue taking it life long

In view of progressive nature of the disease and median lobe projecting in to bladder with significant post void residue of 58 ml ,I would suggest that it is better he undergoes endoscopic resection of enlarged prostate (TURP)

This is a gold standard method of treatment for enlarged prostate practiced world wide that gives good and permanent results which helps the patient to make him free from symptoms and improve his quality of life at this age.

Though he is known diabetic and has ischemic heart disease the science of anesthesiology is so advanced that he will have uneventful surgery and smooth post operative recovery.As such diabetes and IHD are common at this age and this surgery is routinely done in almost all the hospitals .

Please go ahead and get him operated at earliest.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (4 hours later)
Thank you Doctor. I have couple of follow up questions:

1) we would prefer to get a minimally invasive surgery done for this. There seems to be couple of choices available- holep and PvP green light as understood from internet search. Please let me know your opinion on this.

2) based on convenience, we are planning to get the operation done by end of XXXXXXX Looking at the medical condition, is the timing OK or is it too late?

Thank you
Best regards
XXXXXX
doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
TURP is the minimally invasive surgery.

Detailed Answer:
Hello
Thanks for follow up.
TURP ( Trans Urethral Resection Of prostate) is an minimally invasive endoscopic surgery .The energy used is conventional electric current that is commonly used in TURP or Laser energy to burn out the prostate which is commonly advisable when prostate is very large more than 90 gms .

Since the size of the prostate is just 39 gms conventional TURP would be better choice for your father.Do not read too much on internet you would get more confused leave it to the treating Urologist.

As regards getting him operated in XXXXXXX there is no harm in waiting till XXXXXXX .Till then continue taking Silodosin and Dutasteride .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10504 Questions

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Suggest treatment for prostatomegaly

Brief Answer: Surgery is the better option. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that your father has obstructive voiding symptoms due to enlarged prostate which is common at this age. The Silodosin and Dutasteride that he is taking will help to relieve his symptoms to some extent but he has to continue taking it life long In view of progressive nature of the disease and median lobe projecting in to bladder with significant post void residue of 58 ml ,I would suggest that it is better he undergoes endoscopic resection of enlarged prostate (TURP) This is a gold standard method of treatment for enlarged prostate practiced world wide that gives good and permanent results which helps the patient to make him free from symptoms and improve his quality of life at this age. Though he is known diabetic and has ischemic heart disease the science of anesthesiology is so advanced that he will have uneventful surgery and smooth post operative recovery.As such diabetes and IHD are common at this age and this surgery is routinely done in almost all the hospitals . Please go ahead and get him operated at earliest. Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you Thanks and Regards. Dr.Patil.