I see this often in clinic. Someone has an ultrasound scan, the report says ‘enlarged prostate’ or gives a size in grams, and they come in worried about two things: whether it could be cancer, and whether they will need an operation.
A blood test showing a raised PSA is understandably worrying. The most important thing first: a high PSA does not mean you have cancer. It is a finding to look into calmly and carefully, and in many cases the cause is benign.
To make sense of it, it helps to know what PSA is, why it can go up and the sensible order of steps to follow when it comes back high.
It is the question I am asked most often in clinic when I suggest an operation, and it is a reasonable one. Most men who reach this point have been taking tablets for years, have got used to getting up two or three times every night and have put it down to getting older.
The short answer: an operation is considered when the problem is no longer just a nuisance and has started to have consequences, or when medication no longer gives you what you need.
After a HoLEP, most of the questions I get are about the days that follow rather than the operation itself: how long will the catheter stay in, why am I still seeing blood, when can I get back to normal, and what is normal and what is not.
This guide answers those questions. It does not replace the specific instructions you are given when you leave hospital (every patient and every prostate is different), but it will help you know what to expect and when something needs checking.
Leaking urine after prostate surgery is one of the things patients worry about most. It is also one of the things that responds best to a simple routine done consistently.
That routine is pelvic floor exercises, also known as Kegel exercises. You can do them anywhere, you need no equipment and they cost nothing. The trouble is that most people do them wrongly, and done wrongly they are of no use.
This guide covers how to find the right muscle, how to train it and the mistakes to avoid.
It is very common for the prostate to get bigger with age. This is called benign prostatic hyperplasia (BPH): a benign growth, not cancer. The size itself is not the issue. As it grows, the prostate can narrow the channel that urine passes through and cause symptoms that affect your daily life and your sleep.
The good news is that there is treatment for every situation, from medication to minimally invasive laser surgery, which has now replaced conventional surgery in most cases.
As it grows, the prostate squeezes the urethra, which is why passing urine becomes difficult.
