Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a proliferation (multiplication) of the cellular elements of the prostate, leading to an enlarged prostate gland.

Enlargement of Prostate (also known as Benign Prostatic Hyperplasia) occurs when the cells of the gland begin to multiply. This multiplication makes the gland grow larger in size and squeeze the urethra, limiting the flow of urine.

When the prostate enlarges, it may constrict the flow of urine. Nerves within the prostate and bladder may also play a role in causing the following common symptoms:

• Urinary frequency - Increased in number of micturition

• Urinary urgency - urge to pass immediately after getting the sensation of urination

• Nocturia - Needing to get up frequently at night to urinate

• Hesitancy - Difficulty initiating the urinary stream; interrupted, weak stream

• Incomplete bladder emptying - The feeling of persistent residual urine, regardless of the frequency of urination

• Straining - The need strain or push to initiate and maintain urination in order to more fully empty the bladder

• Decreased force of stream - The subjective loss of force of the urinary stream over time

• Dribbling - The loss of small amounts of urine due to a poor urinary stream as well as weak urinary stream.

If you are having trouble urinating, it is generally advisable to visit a urologist. Even though the cause might not be prostate enlargement, it’s important to identify the underlying causes and address them.

No, in most cases, prostate enlargement is caused by Benign Prostate Hyperplasia (BPH). This is a condition that shows up in a very high % of men with age, with almost one-third of men experiencing moderate to severe symptoms by the age of 60. BPH is not linked to cancer and does not increase the risk of getting it.

BPH may lead to Chronic bladder outlet obstruction (BOO) which in turn leads to urinary retention, impaired kidney function, recurrent urinary tract infections, gross hematuria(Blood in urine), and bladder calculi (stones).

While an enlarged prostate can be quite common and doesn’t post any immediate serious complications, in the long term, it can result in complications that include Urinary Tract Infections (UTI), Bladder Stones as well as Bladder or Kidney Damage. In case you have been diagnosed with an enlarged prostate, you should immediately consult a urologist.

Digital rectal examination

• The digital rectal examination (DRE), the examiner can assess prostate size and contour, evaluate for nodules, and detect areas suggestive of malignancy.

Laboratory studies

• Urinalysis - Examine the urine to assess for the presence of blood, leukocytes, bacteria, protein, or glucose

• Urine culture - This may be useful to exclude infectious causes of irritative voiding and is usually performed if the initial urinalysis findings indicate an abnormality

• Prostate-specific antigen (PSA) - as a screening test for prostate cancer.

• Electrolytes, blood urea nitrogen (BUN), and creatinine - to check for any kidney damage secondary to BPH

Ultrasonography - USG

• Ultrasonography is useful for helping to determine bladder, prostate, and kidney injury.

Endoscopy of the lower urinary tract - Cystoscopy.

• Cystoscopy may be indicated in patients scheduled for invasive treatment or in whom a foreign body or malignancy is suspected. In addition, endoscopy may be indicated in patients with a history of sexually transmitted disease (eg, gonococcal urethritis), prolonged catheterization, or trauma.

• Other tests like Flow rate, PVR urine volume, Pressure-flow studies etc., depending on the degree of BPH.

Medical management

• Alpha-adrenergic receptor blockers

• 5-alpha reductase inhibitors

• Phosphodiesterase-5 enzyme inhibitors

• Anticholinergic agents

Surgery

• Transurethral resection of the prostate (TURP) - Part of prostate is resected via urethra (urine pipe) to relieve the obstruction.

• Open prostatectomy - Reserved for patients with very large prostates (>75 g), patients with concomitant bladder stones or bladder diverticula, and patients who cannot be positioned for transurethral surgery

Minimally invasive treatment

• Transurethral incision of the prostate (TUIP)

• Laser treatment - Used to cut or destroy prostate tissue; multiple laser types are available - used as per surgeons discretion.

• Transurethral microwave therapy (TUMT) - Generates heat that causes cell death in the prostate, leading to prostatic contraction and volume reduction

• Transurethral needle ablation of the prostate (TUNA)

• Prostatic stents - Flexible devices that expand when put in place to improve the flow of urine past the prostate

• Laparoscopic prostatectomy

• Implanted devices to relieve prostatic obstruction (eg, UroLift)

Ayu Health offers a range of procedures for Benign Prostatic Hyperplasia (BPH) as well as Prostate Cancer. If you are having any symptoms of either, it is highly recommended to book an appointment today with a urologist.

The cost of the surgery varies based on the severity or complexity of the disease, and the procedure chosen. Please refer to the procedure page for more details on Ayu Health packages.

It is common in males of any age, even baby boys have chances of getting hydrocele

Doctor may order for blood/urine test or Ultrasound scanning as well

Kidney stones can be of many types based on their composition. Some of them are calcium stones, struvite stones, uric acid stones, cystine stones etc. 80% of the stones are composed of calcium.

There is a delicate balance maintained in the urine in our body. When this balance of minerals is disturbed, kidney stones are formed. Some of the reasons for the imbalance are:

• Lack of enough fluid in the body

• Hormonal imbalance

• Intake of a diet which is high in oxalate, sodium and protein

• Family history

When the stone is stationary in the kidney, it does not cause any pain. But, when it moves from the kidney into the ureter, it causes symptoms like:

• Extreme pain in the back and sides

• Pain while passing urine

• Nausea and vomiting

• Red or brown urine

Very small sized stone less than ¼ inch usually can pass through the urinary tract.

The cost of the surgery varies based on the severity or complexity of the disease, and the procedure chosen. Please refer to the procedure page for more details on Ayu Health packages.

Drinking 2-3 litres of water and other fluids can prevent all types of stones.

Nonsteroidal anti-inflammatory drugs or opioids are needed to relieve the pain. Before taking any medication, you should consult with a doctor.

85% of the stones are composed of calcium and the remaining are composed of various substances including uric acid, cystine or struvite.

Doctors always opt to break the stones in the ureter and discharge them while urinating. If the size of the stone is big then, surgery is suggested.

The cost of the surgery varies based on the severity or complexity of the disease, and the procedure chosen. Please refer to the procedure page for more details on Ayu Health packages.

Drinking 3 litres of water and other fluids everyday can prevent all types of stones.

Nonsteroidal anti-inflammatory drugs or opioids are used to relieve the pain. Before taking any medication please consult your doctor.

When the stone is stationary in the kidney, it does not cause any pain. But, when it moves from the kidney into the ureter, it causes symptoms like:

• Extreme pain in the back and sides

• Pain while passing urine

• Nausea and vomiting

• Red or brown urine

It is best to avoid food that is rich in minerals that form ureter stones. Some of the diet recommendations are:

• High intake of water and fluids

• Avoiding salty, high protein and fatty food

• Having citrus fruits like lemon, oranges, sweet lime is helpful

There are several treatments available for removing ureter stones. The doctor will recommend the treatment based on the size of the stones. Different types of treatments available for ureter stones are:

• Extracorporeal Shock Wave Lithotripsy (ESWL)

• Retrograde intrarenal surgery (RIRS)

• Percutaneous Nephrolithotomy (PCNL)

Extracorporeal Shock Wave Lithotripsy (ESWL) is an outpatient procedure and the patient can recover within 24 hours of the treatment.

There are very less complications through this treatment. Some of the risks may be:

• Mild pain when the stones pass through urine

• Urinary tract infection

• Bleeding in the urinary system

• Inability to pass urine

Some of the risks involved with the RIRS procedure may be bleeding, infection, and injury to the ureter.

Percutaneous Nephrolithotomy (PCNL) procedure is done when there are large stones that are more than 2 cm in size. It is also used when the ureter stones have an irregular shape.

Today, many parents have their sons circumcised for religious reasons. Medically it decreases risk of urinary tract and sexually transmitted infections.

The foreskin is freed from the head of the penis and the excess foreskin is clipped off.

If a child has too much foreskin after a first circumcision, it is best not to wait too long to correct it. The problem typically will only get worse if not treated. Boys do not grow longer than usual foreskin.

Yes, adult circumcision is often a simple procedure though its considered as larger surgery than it is in infants

Erections might cause pain for a few days after the circumcision. This pain usually goes away as the erection does and it will not harm the wound and may aid in healing, but one should avoid sexual stimulation during this time.

Fit to resume your normal lifestyle next day post laser circumcision. Suggest to wear loose-fitting clothes and also avoid sexual activity for at least 3-4 weeks.

Laser circumcision is a painless and bloodless procedure with no wounds and scar. Can resume to work the next day itself.

Varicocele is not a life-threatening condition. However, if it is left untreated, a varicocele can affect the testicles. In very rare cases, varicocele might cause problems fathering a child.

A varicocele is one of the common causes of low sperm production and low sperm quality that can be the main cause of infertility.

A testicular ultrasound helps to get the images of testicles and the tissues in the scrotum. This ultrasound is also called a testicular sonogram.

Varicoceles occur after puberty age. Once a varicocele is formed, it does not go away with treatment.

In very rare cases, a varicocele can burst open when there is an increase in abdominal pressure. The increased venous pressure can rupture the varicocele.

Walking will prevent the formation of blood clots after the surgery. Although there is some pain and discomfort after surgery, waking boosts the blood flow and prevents problems like pneumonia and constipation.