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Benign Prostatic Hyperplasia

Jul 19, 2026 Posted by admin Urology 0 comments

Overview

An enlarged prostate is often called benign prostatic hyperplasia (BPH). It is not cancer, and it does not raise your risk for prostate cancer.

The prostate is a gland that produces some of the fluid that carries sperm during ejaculation. The prostate gland surrounds the urethra, the tube through which urine passes out of the body. An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. If you have BPH, you should have a yearly assessment to monitor your symptoms and see if you need changes in treatment.

Many treatments can help BPH. These include medicines, surgery and other procedures. Your health care provider can help you choose. The right option depends on things such as:

  • Your symptoms.
  • The size of your prostate.
  • Other health problems you might have.

Causes

The actual cause of prostate enlargement is unknown. Factors linked to aging and changes in the cells of the testicles may have a role in the growth of the gland, as well as testosterone levels. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.

Also, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size. However, this is not a standard treatment for an enlarged prostate.

Symptoms

Common symptoms of BPH include:

  • Dribbling at the end of urinating
  • Inability to urinate (urinary retention)
  • Incomplete emptying of your bladder
  • Incontinence
  • Needing to urinate 2 or more times per night
  • Pain with urination or bloody urine (these may indicate infection)
  • Slowed or delayed start of the urinary stream
  • Straining to urinate
  • Strong and sudden urge to urinate
  • Weak urine stream

Diagnosis

Your health care provider likely will start by asking questions about your symptoms. You’ll also get a physical exam. This exam is likely to include:

  • Digital rectal exam. The provider inserts a finger into your rectum to check if your prostate is enlarged.
  • Urine test. A lab checks a sample of your urine to find out if you have an illness or other problems that can cause the same symptoms as those of BPH.
  • Blood test. The results can show if you have kidney problems.

After that, you might need other tests that can help confirm an enlarged prostate. These tests include:

  • Prostate-specific antigen (PSA) blood test. PSA is a protein made in the prostate. PSA levels go up when the prostate becomes enlarged. But higher PSA levels also can be due to recent procedures, illnesses, surgery or prostate cancer.
  • Urinary flow test. You pee into a container attached to a machine. The machine measures how strong your urine flow is and how much urine you pass. Test results can show over time whether your condition is getting better or worse.
  • Postvoid residual volume test. This test measures whether you can empty your bladder fully. The test can be done using an imaging exam called ultrasound. Or it can be done with a tube called a catheter placed into your bladder after you pee to measure how much urine is left in the bladder.
  • 24-hour voiding diary. This involves noting how often and how much you pee. It might be extra helpful if you make more than a third of your daily urine at night.

Treatment

Many treatments are available for enlarged prostate. These include medicines, surgery and procedures that involve smaller, fewer or no cuts. The best treatment choice for you depends on:

  • The size of your prostate.
  • Your age.
  • Your overall health.
  • How serious your symptoms are.

If your symptoms don’t get in the way of your life, you might decide to put off treatment. Instead, you could wait to see if your symptoms change or get worse. For some people, symptoms of BPH can ease without treatment.

SELF-CARE

For mild symptoms:

  • Urinate when you first get the urge. Also, go to the bathroom on a timed schedule, even if you don’t feel a need to urinate.
  • Avoid alcohol and caffeine, especially after dinner.
  • Do not drink a lot of fluid all at once. Spread out fluids during the day. Avoid drinking fluids within 2 hours of bedtime.
  • Try not to take over-the-counter cold and sinus medicines that contain decongestants or antihistamines. These medicines can increase BPH symptoms.
  • Keep warm and exercise regularly. Cold weather and lack of physical activity may worsen symptoms.
  • Reduce stress. Nervousness and tension can lead to more frequent urination.

MEDICINES

Alpha-1 blockers are a class of medicines, some of which have been used to treat high blood pressure. These medicines relax the muscles of the bladder neck and prostate. This allows easier urination. Most people who take alpha-1 blockers notice improvement in their symptoms, usually within 3 to 7 days after starting the medicine.

There are many types of surgeries and other procedures that can treat an enlarged prostate.

Transurethral resection of the prostate (TURP)

A thin tool with a light, called a scope, is inserted into the urethra. The surgeon removes all but the outer part of the prostate. TURP often relieves symptoms quickly. Some people have a stronger urine flow soon after the procedure too. After TURP, you might need a catheter to drain your bladder for a little while.

Transurethral incision of the prostate (TUIP)

A lighted scope is inserted into the urethra. The surgeon makes one or two small cuts in the prostate gland. This makes it easier for urine to pass through the urethra. TUIP might be an option if you have a small or slightly enlarged prostate gland. It also may be an option if you have health problems that make other surgeries too risky.

Transurethral microwave thermotherapy (TUMT)

A special catheter is placed through the urethra into the prostate area. Microwave energy from the catheter destroys the inner portion of the enlarged prostate gland. This shrinks the prostate and eases urine flow. TUMT might relieve only some of your symptoms. It also might take some time before you notice results. In general, this surgery is used only on small prostates in special situations because the treatment might be needed again.

Laser therapy

A high-energy laser destroys or removes overgrown prostate tissue. Laser therapy has a lower risk of side effects than does nonlaser surgery. It might be used in people who shouldn’t have other prostate procedures because they take blood-thinning medicines.

Laser therapy options include:

  • Ablative procedures. These destroy prostate tissue that blocks urine flow. Types of these procedures include photoselective vaporization of the prostate (PVP) and holmium laser ablation of the prostate. Ablative procedures can cause irritating symptoms after surgery. In rare cases, another procedure to remove prostate tissue might be needed at some point.
  • Enucleative procedures. These treatments include holmium laser enucleation of the prostate (HoLEP). In general, they remove all the prostate tissue blocking urine flow and prevent tissue from growing back. The removed tissue can be checked for prostate cancer and other health problems.

Prostate lift

Special tags are used to compress the sides of the prostate. This can improve the flow of urine. A prostate lift might be an option if the middle section of the prostate gland doesn’t get in the way of urine flow. It’s less likely to cause sexual side effects than are many other surgical treatments.

Water vapor thermal therapy (WVTT)

A device is placed in the urethra. It turns water into steam. This wears away extra prostate tissue. WVTT can ease symptoms of an enlarged prostate. It is less likely to cause sexual side effects compared with many other surgical treatments.

Robotic waterjet treatment

This procedure uses imaging tests and robotic tools to guide a device into the urethra. The device releases tiny, powerful jets of water to remove extra prostate tissue. This can ease symptoms of an enlarged prostate. Robotic waterjet treatment can cause some of the same side effects that TURP can cause.

Open or robot-assisted prostatectomy

One or more cuts are made in the lower stomach area. This lets the surgeon reach the prostate and remove tissue. In general, this type of surgery is done if you have a large or very large prostate. A short hospital stay is often needed afterward. The surgery is linked with a higher risk of needing donated blood due to bleeding.

Prostate artery embolization (PAE)

You may be offered prostate artery embolization as a treatment option for BPH. In this procedure, the blood supply to the prostate is blocked in chosen areas. This causes the prostate to get smaller. Evidence suggests there may be both short-term and long-term benefits of this procedure, including improved urinary symptoms, for certain people with BPH.

It’s important to talk with your healthcare team about the risks and benefits of this procedure. PAE should be done only by a healthcare professional who has been specially trained to perform PAE procedures. This type of healthcare professional is called an interventional radiologist. This is a doctor with special training in performing procedures done using imaging methods, such as X-ray, MRI or ultrasound, to guide them.

Follow-up care

Your follow-up care will depend on the technique used to treat your enlarged prostate. Your health care provider should tell you what activities to stay away from and for how long.

 Above article is for information purpose only ,If you find any one suffering with enlarged prostate please feel free to email us on query@gtsmeditour.com and get assistance for best available treatment abroad.

 

Transobturator Tape

Jul 19, 2026 Posted by admin Urology 0 comments

Overview

TOT stands for Trt is a minimally invasive, outpatient surgical procedure used to treat Stress Urinary Incontinence (SUI) in women. The technique involves placing a synthetic mesh “hammock” under the mid-urethra to support it, preventing leakage when a patient coughs, sneezes, or exerts physical pressure.

TOT (Transobturator Tape) and TVT (Tension-free Vaginal Tape)

are minimally invasive surgical techniques designed to treat urinary incontinence, particularly stress urinary incontinence (SUI). This condition occurs when physical activities such as coughing, sneezing, laughing, or exercising put pressure on the bladder, leading to involuntary leakage of urine. The primary purpose of these procedures is to provide support to the urethra, helping to prevent involuntary leakage and improve the quality of life for those affected.

During the TOT and TVT procedures, a mesh tape is placed under the mid-urethra to create a supportive sling. This tape acts as a hammock, providing stability to the urethra and allowing it to function more effectively. The procedures are typically performed under local or general anesthesia and can often be completed in an outpatient setting, meaning patients can return home the same day.

Both procedures have gained popularity due to their effectiveness and relatively quick recovery times. They are designed to be minimally invasive, which means they involve smaller incisions and less tissue disruption compared to traditional surgical methods. This approach not only reduces pain and scarring but also shortens the recovery period, allowing patients to return to their daily activities sooner.

Symptoms

Symptoms of stress urinary incontinence include:

  • Involuntary leakage of urine during physical activities
  • A feeling of urgency to urinate
  • Frequent urination, especially during the day
  • Difficulty controlling urination when laughing, sneezing, or coughing

These symptoms can arise from various factors, including pregnancy, childbirth, hormonal changes, obesity, and aging. In some cases, previous pelvic surgeries or conditions that weaken the pelvic floor muscles can also contribute to the development of urinary incontinence.

Before recommending the TOT or TVT procedures, healthcare providers typically explore conservative treatment options, such as pelvic floor exercises (Kegel exercises), lifestyle modifications, and medications. However, if these methods do not provide sufficient relief, or if the incontinence is severe, surgical intervention may be necessary.

Types of TOT/TVT Sling Procedures for Incontinence

While the TOT and TVT procedures are the two primary techniques used for treating stress urinary incontinence, they differ slightly in their approach and placement of the mesh tape.

  1. TVT (Tension-free Vaginal Tape): This procedure involves placing a mesh tape under the mid-urethra through a small incision in the vaginal wall. The tape is then anchored to the pelvic tissue, providing support to the urethra. The tension-free aspect of the procedure allows for natural movement and function of the urethra, reducing the risk of complications associated with excessive tension.
  2. TOT (Transobturator Tape): Similar to the TVT procedure, the TOT involves placing a mesh tape under the mid-urethra. However, the tape is inserted through the obturator foramen, a bony opening in the pelvis, which allows for a different approach to anchoring the tape. This technique is designed to minimize the risk of bladder and bowel injury, making it a favorable option for some patients.

 

Contraindications for TOT/TVT Sling Procedures for Incontinence

While the TOT (Transobturator Tape) and TVT (Tension-Free Vaginal Tape) sling procedures are effective treatments for urinary incontinence, certain conditions or factors may make a patient unsuitable for these procedures. Understanding these contraindications is crucial for ensuring patient safety and optimal outcomes.

  1. Active Urinary Tract Infection (UTI): Patients with an active UTI should not undergo the procedure until the infection is treated. An infection can complicate recovery and increase the risk of complications.
  2. Severe Pelvic Organ Prolapse: Significant prolapse of the bladder, uterus, or rectum may require different surgical interventions. If the prolapse is severe, it may affect the success of the sling procedure.
  3. Neurological Disorders: Conditions that affect bladder function, such as multiple sclerosis or spinal cord injuries, may not respond well to sling procedures. These patients may require alternative treatments.
  4. Obesity: Patients with a high body mass index (BMI) may face increased surgical risks and complications. Weight loss may be recommended before considering the procedure.
  5. Previous Pelvic Surgery: A history of extensive pelvic surgery can lead to scar tissue formation, which may complicate the placement of the sling and affect the procedure’s success.
  6. Connective Tissue Disorders: Conditions like Ehlers-Danlos syndrome can affect tissue integrity and healing, potentially leading to complications post-surgery.
  7. Pregnancy: Women who are currently pregnant or planning to become pregnant soon should postpone the procedure, as pregnancy can affect bladder function and the success of the sling.
  8. Allergies to Materials: Patients with known allergies to the materials used in the sling, such as polypropylene, should discuss alternative options with their healthcare provider.
  9. Inability to Follow Post-Operative Instructions: Patients who may struggle to adhere to post-operative care instructions may not be suitable candidates, as proper care is essential for recovery.
  10. Uncontrolled Medical Conditions: Patients with uncontrolled diabetes, hypertension, or other significant medical issues may face higher risks during surgery and should be stabilized before considering the procedure.

Common Risks:

  • Pain: Some patients may experience discomfort or pain at the incision sites or in the pelvic area.
  • Urinary Retention: Difficulty urinating can occur if the sling is too tight. This may require temporary catheterization.
  • Infection: There is a risk of infection at the surgical site or in the urinary tract.
  • Bleeding: Minor bleeding is common, but excessive bleeding may require further intervention.

Outcomes

  • Reduced Dependence on Products: Many patients find they no longer need to rely on pads or other incontinence products, leading to cost savings and increased comfort.
  • Better Sleep Quality: With reduced nighttime incontinence, patients often experience improved sleep quality, which contributes to overall well-being.
  • Long-Term Effectiveness: Studies show that the majority of patients experience long-term success with these procedures, with many reporting continued improvement in symptoms years after surgery.

While the TOT and TVT sling procedures are popular options for treating urinary incontinence, Burch colposuspension is another surgical alternative that patients may consider.

Above article is for information purpose only, if anything abnormal you find in regards to your health, please feel free to contact us on query@gtsmeditour.com and can share your medical reports for further evaluation with our consultants abroad and get value treatment with our assistance.