After the age of 30, the prostate, that small but vital organ of the reproductive system, begins to enlarge. A condition that can go almost unnoticed in the course of life, as well as, it can be the beginning of a problem that, in some cases, often becomes serious. Prostatic hyperplasia.
For example, if you have changes when you urinate, such as delayed urination, loss of force, or dribbling after urination, you may have benign prostatic hyperplasia, BPH, a benign enlargement of the prostate.
The prostate is the male gland that is located in the lower part of the pelvis, below the bladder. Through it passes the urethra or conduit that communicates the bladder with the outside.
“When the gland grows in a benign way, it is known as benign prostatic hyperplasia (BPH). This abnormal growth can begin to occur with effects on functions, such as urine, after the age of 40, and gradually or acutely, triggering urinary symptoms with difficulty in urination”, says the doctor; Jorge Eduardo Sejnaui, urologist at the Medical Center.
Consultation with the doctor will determine the actual situation. The worrying thing, according to urologists, is that most men see these types of changes as normal and rule out seeing a doctor early. Most do it late, when quality of life has been considerably affected and there is additional damage, especially to the bladder.
“Patients come to the consultation encouraged by their wives, because the nights become a torment, with two and more trips to the bathroom. The bladder fails to eliminate all of the urine. This affects the man and his partner, because this situation does not allow us to sleep”, says Dr. Jorge Sejnaui, urologist at the Medical Center.
“My situation became critical, because it was not only the three and more times that I went to the bathroom during the night, that is to say that I did not sleep well. Then, when we were going to leave the house, the first thing he would ask was if there was a bathroom in the place where we were going,” says Luis Carlos López, a 57-year-old merchant.
He remembers that the disease altered his family and social life and that it led him to consult, despite the fear that visiting the urologist always caused him. His sister, who also had the same problem, had had a difficult experience with the surgery she had.
Indeed, Dr. Sejnaui says that nocturnal urination is followed by an increase in the number of daytime urinations and often produces acute urinary retention (ARO) or difficulty urinating, with pain in the hypogastrium (lower abdomen).
Dr. Sejnaui explains that the growth begins to obstruct the urethra and therefore the normal passage of urine. At first the bladder manages to evacuate, but then it begins to retain urine, which can become a serious problem.
With the obstruction of the urethra, the kidneys become dilated. In this chronic fight of the bladder, it causes the ureters, too, to dilate and, in extreme cases, to produce chronic kidney damage.
Advances in research in the last two decades have led to the development of drugs that relax the gland and reduce obstruction, and others that reduce the size of the prostate and in the process protect the risk of cancer by up to 25%. Today there are already two medicines in one.
However, according to urologists, surgery is still the ideal, despite the reservation of men towards this alternative.
Open surgery, which allows removing the prostate and leaving only the capsule. It can also be done by laparoscopy, depending on the volume of the prostate. Both options offer good results.
There is also surgery through the urethra (TUR) or transurethral resection, where the surgeon with a special instrument makes various cuts and extracts the fragments of the gland in parts until only the capsule is left.
green laser
One of the greatest advances in recent years is the green laser, a new technique that allows vaporization of prostate tissue. A green light or energy is responsible for vaporizing the hemoglobin. There are no cuts and minimal bleeding, the laser gradually disappears the prostate tissue and frees the space for the urethra.
“It is safer, with fewer risks, it is ambulatory, that is, the patient goes home after the procedure, and his recovery is faster. The probe is left in for only 24 hours, while in other surgeries it must remain for between five and seven days”, says Dr. Sejnaui.
In addition to not requiring hospitalization (other surgeries require two to three days) the patient’s disability is one week, while for other alternatives it can be extended to a month and a month and a half.
It is an ideal technique in elderly patients and with other underlying diseases, because it is a low-risk, less aggressive, safer, and minimally invasive procedure.