Enlarged Prostate Treatment Guide - Leeds & Yorkshire
Urinary symptoms can have several causes, and navigating the available treatment options is not always straightforward.
Mr Aldiwani offers clear, personalised assessment and advice, with treatments ranging from lifestyle changes and medication to minimally invasive procedures and prostate surgery.
Understand the assessment below
Urinary symptoms are common, but they don't have to be accepted
Benign prostate enlargement, also known as BPH, is a common cause of urinary symptoms in men.
As the prostate enlarges, it can narrow the urinary channel and make it harder for the bladder to empty. However, not every urinary symptom is caused by prostate obstruction. Bladder overactivity, infection, medication, diabetes and other conditions can produce similar symptoms.
The first step is to understand whether symptoms are caused mainly by the prostate, the bladder, or a combination of both.
The best treatment is not simply the newest procedure
Symptoms of an enlarged prostate
Symptoms can relate to urinary flow (voiding), bladder storage, or both.
Voiding Symptoms
- Slow or weak urinary stream
- Difficulty starting
- Stopping and starting
- Straining
- Incomplete emptying
- Dribbling afterwards
Storage Symptoms
- Passing urine frequently
- Getting up at night
- Urgency
- Difficulty postponing urination
- Urge leakage
Understanding the cause of your urinary symptoms
A good treatment decision starts with a proper assessment of the prostate, bladder and personal priorities.
Consultation and symptom score
Your symptoms, impact on daily life, medical history and medication are reviewed.
An IPSS questionnaire is a helpful tool to benchmark your current symptoms.
Examination and PSA
A prostate examination and PSA blood test may be recommended depending on age and risk.
Flow rate and residual urine
A flow test measures the stream, while ultrasound assesses bladder emptying.
Prostate size and anatomy
Not all prostates are alike. Ultrasound, cystoscopy or imaging may be used to assess prostate size, shape and obstruction. This is particularly important to enable the most appropriate individualised treatment plan.
Personal priorities
Recovery, ejaculation, durability and avoiding long-term medication all matter.
Complications of an enlarged prostate
Most men experience bothersome urinary symptoms rather than serious harm. However, if obstruction becomes significant or the bladder does not empty properly, complications can develop.
Acute Urinary Retention
A sudden inability to pass urine. This is usually painful and requires urgent treatment with a urinary catheter.
Chronic urinary retention
The bladder may gradually retain increasing amounts of urine. Over time, it can become overstretched and less effective at emptying.
Recurrent urinary infections
Urine left behind in the bladder can increase the risk of repeated urinary tract infections. This can be normal urine infections or infections of prostate, kidneys or testicles.
Bladder stones
Stagnant urine may contribute to stone formation, causing pain, infection, bleeding or interruption of the urinary stream.
Bladder damage
Long-standing obstruction can cause thickening, reduced flexibility and weakening of the bladder muscle.
Pressure on the kidneys
Severe or prolonged retention can occasionally cause kidney swelling and reduced kidney function, requiring prompt assessment.
Bleeding
Enlarged prostates can bleed without trigger due to friable surface blood vesssels.
When surgery may be considered
Recurrent retention, repeated infections, bladder stones, kidney impairment or persistent bleeding may be reasons to consider surgery rather than continuing with medication alone.
Seek urgent medical attention
If you are suddenly unable to pass urine, develop severe lower abdominal pain, have fever with urinary symptoms, or feel acutely unwell.
New night-time bedwetting is an important warning sign of high pressure chronic retention and may indicate kidney risk of kidney damage.
Common treatment options
Many surgical treatments have been developed. Some have lasted the test of time. Each has a different balance of recovery, symptom improvement, durability and sexual side effects. (Please note that we are not able to offer all of these options privately)
Tablets
Often first treatment for mild to moderate symptoms. Easy to start, but usually requires ongoing use.
UroLift
Implants hold prostate tissue away from the urinary channel. Recovery is usually quick and ejaculation is often preserved although treatment effect is more modest.
Rezūm
Steam treats obstructing tissue, which gradually shrinks. Improvement is slower and a temporary catheter is common.
TURP
An established operation that removes obstructing tissue through the urethra using a electrode loop.
HoLEP
A durable tissue-removing procedure suitable across a broad range of prostate sizes.
Which enlarged prostate treatment is best?
There is no single best operation for every patient. The right option depends on anatomy, bladder function, treatment goals and the trade-offs you are willing to accept.
Prostate size and shape
Severity of obstruction
Bladder function
Retention or catheter dependence
Bleeding risk and anti-coagulants
Importance of preserving ejaculation
Recovery vs durability
Possibilty of retreatment
Frequently asked questions
The questions below explain how private prostate surgery works in Leeds. Not all treatments are available privately. Some are available in other hospitals and would require referral.
Does an enlarged prostate mean cancer?
No. Benign prostate enlargement is not prostate cancer, although both can occur at the same time.
Which treatments are best at preserving ejaculation?
UroLift and Rezūm generally have a lower risk of ejaculatory change than TURP or HoLEP.
When should I consider surgery?
When symptoms remain troublesome despite medication, medication causes side effects, or complications develop.
Which treatments are most durable?
Procedures removing more tissue, such as HoLEP and TURP, generally offer more durable relief. These are often referred to as cavitating procedures?
Which BPH treatments are being offered?
Mr Aldiwani has first hand experience with all of the treatment options mentioned. Due to technical constraints we are limited to offering Bipolar TURP, Urolift and Rezum only. HoLEP is available for select cases. Contact us for more information.
Aquablation would require external referral.
Arrange a specialist consultation
For an individualised private assessment about any of the symptoms above or to discuss prostate surgery.
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