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Do I need surgery for benign prostate enlargement?

Q: I am 70 years old. I have apparently benign prostate enlargement (30 gm), urine retention is 32 cc, mild dilation of both kidneys (right 10.7x4.7, left 11x5.4). The problem is continuing for more than a year. I have been taking Urimax 0.4 regularly. Is it a fit case for TURP surgery or can it be treated with medicine or some other therapy? Is this a serious problem? I have high blood pressure but it is strictly under control. Blood sugar is normal.

A:The common notion that if prostate is enlarged it is diseased, is not true. The prostatic disease is not its size but the obstruction it produces in flow of urine, which leads to inconvenience of varying degree ranging from mild difficulty in passing urine to complete retention of urine suddenly. Kidneys get affected rarely, in almost 4% cases. The degree of obstruction is assessed by ultrasound which, in your case shows 32 cc. Residual urine is ok. More important than your reports are your symptoms. If you feel obstruction in the form of decreased flow, interruptions in flow, longer voiding time, getting up at night over 2-3 times, then you have symptoms of so called enlarged prostate. You need to get a uroflow done. Regarding the dilatation of kidneys, it can be seen if you were holding urine more than your normal capacity. It is a common mistake done at ultrasound on insisting by the ultrasonologist. Tell the ultrasonologist to recheck the kidneys after you pass urine.

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