PROSTATE ENLARGEMENT

What is the Prostate? What is the function of the prostate?

The prostate is a approximately walnut-sized gland tissue (10-20 gr) located just below the urinary bladder, where some of the semen content is produced in men. The fluids secreted by the prostate gland enable the semen to become fluid in the vagina and, thanks to the substances it contains, it enables sperms to survive in the vaginal environment by protecting them from environmental factors.

What Are the Most Common Diseases of the Prostate?

There are 3 common diseases;

1. Prostate Inflammation (Prostatitis)
2. Prostate Gland Enlargement (Benign Prostatic Hyperplasia)
3. Prostate Cancer

What are the Symptoms of Prostate Inflammation (Prostatitis)?

It is an inflammatory disease of the prostate and surrounding tissues and, often affects young and reproductive men. The most common findings and complaints; fever, weakness, burning while urinating, difficulty urinating, urgent need to urinate, bloody urine, pain around the anus, painful ejaculation and erection problems.

What is the Benign Prostatic Hyperplasia?

It is a condition characterized by the inability urinating comfortably as a result of the prostate that grows with age puts pressure on the urethra of which it surrounded. This situation causes problems with urination in about half of the men in their 50s and 60s, and in 90% of men in the older age group. Because, when the diagnosis and treatment of benign prostate enlargement, which is important for early diagnosis and treatment, is delayed, kidney failure, bladder stones, recurrent urinary tract infections and even bladder cancer related to chronic irritation can develop.

What are the Symptoms of Prostate Enlargement?

Frequent urination, urination at night, urge to urinate suddenly, urinary incontinence, weak urine flow, intermittent urination, difficulty urinating, feeling that the bladder is not emptied completely and dripping on underwear at the end of urination are the most common complaints.

How Are Prostate Diseases Diagnosed?

It is important to listen to the patient’s medical history carefully and in detail. Finger examination of the prostate from the anus is also important. Other tests that may need to be done according to the patient’s condition are:

– Prostate-Specific Antigen (PSA) Test: It is a blood test for the possibility of prostate cancer.
– Urine Flow Test: It shows urine flow rate, voiding pattern and residual urine amount.
– Ultrasonography: It allows imaging of the kidney, bladder and prostate.
– Cystoscopy: It is the direct visual examination of the external urethra and bladder using an instrument.

Treatment of Benign Prostatic Hyperplasia (BPH)

The treatment to be applied in benign prostate enlargement is determined according to the condition of the patient. Depending on the severity of the patient’s complaints, close follow-up, medication, focal therapy or surgical methods may be preferred for treatment. The two most common surgical methods today are TUR and HoLEP techniques.

Transurethral resection of the prostate (TURP): It is an endoscopic surgical method that is most commonly used in the surgical treatment of benign prostatic enlargement (BPH) and accepted as the gold standard technique in the treatment of prostates smaller than 80 grams.

Holmium Laser Enucleation of the Prostate (HoLEP): In this method, also known as Laser Prostate Surgery, the enlarged prostate inner tissue (adenoma) is peeled out from its capsule with the help of laser. Then the adenoma is cut into small pieces and taken out. This process is performed by entering through the urethra using an endoscope without any incision.

What is Prostate Cancer?

it is a separate disease that is not caused by (BPH) even it can be found together with benign prostate enlargement (BPH), by the age group it affects (men over 50 years old). Until it reaches advanced stages, it usually causes no symptoms or signs. For this reason, it is recommended that every man over the age of 50 should visit a urologist at least once a year for prostate control, whether or not he has any complaints about urine.

Why is Early Diagnosis Important in Prostate Cancer?

Prostate cancer is the most common type of cancer in men in western countries, according to the data of the American Cancer Society, and it accounts for about a quarter of all cancer cases. In our country, it is one of the most frequently observed cancer types together with lung and bladder cancer in men.

In recent studies, although a man’s lifetime risk of developing prostate cancer is between 15-20%, it is reported that the risk of death due to this disease is around 3%. This is related to the fact that although prostate cancer is a common cancer, it has a very high chance of recovery, especially when it is diagnosed at an early stage and a correct treatment scheme is applied.

What is Prostate Fusion Biopsy?

Prostate Fusion Biopsy or MR Fusion Biopsy is a highly sensitive “smart biopsy” method that detects cancer-suspicious foci in the prostate and provides point shot for these targets.

In the procedure, first of all, multi-slice MR images of the prostate are examined and suspicious foci in terms of cancer are marked. Later, MR images are processed with the help of a special software and combined with ultrasound images, and after the images are made 3-dimensional, the biopsy needle is directed to the marked suspicious points with the help of a robotic arm, and targeted biopsy is performed. This method has a very high accuracy rate (98%) in the diagnosis of prostate cancer, cancer cases are not missed and repetitive biopsies are not required as in standard biopsies.

What is High Intensity Focused Ultrasound (HIFU)?

It is the process of destroying cancer cells in the prostate with the help of high intensity focused sound waves. With the ultrasound source placed from the anus under the condition of general anesthesia, the targeted points in the prostate tissue are destroyed by the high heat energy generated by HIFU.

The HIFU method, which has been prominent as a non-surgical treatment in recent years, provides great advantages in prostate cancer cases. Risks such as urinary incontinence or sexual dysfunction, which are among the possible side effects of classical surgery, are eliminated thanks to being able to treat only the diseased area of the prostate without damaging the surrounding tissues particularly using the latest version of HIFU technology.