Dr Michael Wong is a USA-fellowship trained senior urologist with an exceptional international standing, having received some of the highest recognitions across three continents.
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Enlarged Prostate (BPH)
The prostate is a walnut-sized gland in the male reproductive system that surrounds the urethra and produces seminal fluid. As men age, the prostate gland tends to enlarge, leading to various urinary symptoms. Depending on the severity, an enlarged prostate is typically treated with medication or surgical intervention.
Medically reviewed by Dr Michael Wong, Medical Director & Senior Consultant Urologist
FAMS (Urology),FICS (USA),FRCS (Edinburgh),M Med (Surgery),MBBS (S’pore)
What Is Benign Prostatic Hyperplasia (BPH)?
An enlarged prostate, also known as benign prostatic hyperplasia (BPH), is a non-cancerous swelling that can potentially grow to the size of a tennis ball and exerting pressure on the urethra. BPH is a urinary condition that commonly affects men over the age of 50 in Singapore.
What Are the Symptoms of an Enlarged Prostate?
The symptoms of an enlarged prostate are typically mild at first, but they can worsen over time without treatment. Some common symptoms include:
Dribbling at the end of urination
Difficulty starting urination
Straining to urinate
A feeling of not fully emptying the bladder
Repeatedly urinating at night (nocturia)
Urinary incontinence
Presence of blood in the urine (haematuria)
Discomfort or pain during urination
If you experience pain while urinating or your urine contains blood, please schedule a consultation with a urologist immediately.
A doctor typically detects an enlarged prostate based on a patient's medical history and physical examination. Diagnostic tests may include:
Digital Rectal Examination
The doctor will gently insert their gloved finger inside the rectum and palpate the posterior wall of the prostate gland to assess its size and any abnormalities.
Urine Flow Test (Uroflowmetry)
A patient will be asked to urinate in a container connected to a machine that measures the speed of the urine stream and the amount of urine passed.
Post-Void Residual Volume Test
This uses an ultrasound to check if the bladder empties fully and if any urine remains after urination.
Urinalysis
A urine sample is collected and examined to look for signs of infection, blood, bladder cancer, or other factors that may indicate potential causes of an enlarged prostate.
Cystoscopy
A lighted scope is inserted into the urethra to allow the doctor to inspect the inside of the prostate and bladder.
Prostate-Specific Antigen (PSA) Test
While primarily used to screen for prostate cancer, this blood test measures whether the PSA is abnormally high, indicating prostatic hyperplasia or prostate inflammation.
Treatments for Benign Prostatic Hyperplasia (BPH)
Patients with mild symptoms may not require any treatment. The doctor may recommend only monitoring the condition over regular visits. Sometimes, the doctor will check the severity of BPH and the patient's symptoms to decide if medication, a minimally invasive procedure, or surgery is required.
Medications
A doctor typically prescribes medications as the first line of treatment to help manage symptoms. These include:
Alpha-blockers
- These medications improve urinary flow by relaxing the muscles in the prostate and bladder.
5-Alpha Reductase Inhibitors
- These drugs inhibit the production of dihydrotestosterone to help shrink excess prostate tissue and relieve symptoms.
Minimally Invasive Procedures
If medication does not relieve the patient's symptoms, the doctor may consider minimally invasive techniques, such as:
Water Vapour Therapy
- This procedure involves inserting sterile water vapour using a cystoscope into the prostate gland to ablate (remove) excess prostate tissue.
Prostatic Urethral Lift (PUL)
- This treatment involves placing small, permanent implants to lift and hold the prostate lobes apart and widen the urethra passage for improved urine flow.
Transurethral Microwave Thermotherapy (TUMT)
- This technique employs microwave heating to destroy prostate tissue allowing urine to pass through.
Surgical Procedures
In severe cases, the doctor may perform a surgical procedure to remove excess prostate tissues.
Transurethral Resection of the Prostate (TURP)
- This surgery involves inserting a resectoscope with a wire loop through the urethra to remove the obstructing prostate tissue in small sections.
Laser Prostatectomy
- This procedure uses high-powered laser energy, delivered through a thin cystoscope tube, to destroy overgrown prostatic tissue.
Transurethral Incision of the Prostate
- Unlike TURP, this procedure does not remove the prostate tissue. Instead, a small incision is made in the prostate and bladder neck to minimise pressure on the urethra and allow easier urine passage.
FAQs About Enlarged Prostate
Will BPH impact my daily life?
BPH can affect a man's quality of life if left untreated. Symptoms like frequent urination, nocturia, and trouble emptying the bladder can disrupt sleep patterns, reduce work productivity, and limit social activities.
Is drinking lots of water enough to prevent prostate enlargement?
While maintaining hydration is essential for overall well-being, drinking plenty of water alone is insufficient to prevent or treat BPH. Managing this condition effectively requires both proper medical treatment and lifestyle changes.
Is BPH the same as prostate cancer?
BPH and prostate cancer are not the same. BPH is a non-cancerous enlargement of the prostate gland, whereas prostate cancer occurs when malignant cells proliferate uncontrollably within the prostate tissue.
Let us help you
Restore your urological health.
Make an appointment with Dr Michael Wong to receive a tailored, supportive and targeted care plan.
Office Location
3 Mount Elizabeth Road, #10-09, Mount Elizabeth Medical Centre, Singapore 228510
