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Do I need surgery for enlarged prostate?

Q: I am a 61 years old male. After a master health check up, I came to know that my prostate gland is enlarged; measuring 4.1 x 4.1 x 4.0 cm and the echotexture of the liver is homogeneous. The uroflow average flow rate is 3 ml/s and peak flow rate is 24 ml/s per 5 seconds. A doctor has prescribed me Alfusin-D and advised me to get operated. Another doctor has suggested me to take the Floter tablet and has told me that prostate enlargement is common after the age of 50 years. What should I do? Do I need to get operated for prostate enlargement?

A:According to your description, it seems that you have been diagnosed with prostate enlargement on a routine check up. I am not sure what lower urinary tract symptoms (LUTS)you have at present. LUTS include various voiding symptoms like weak flow, delay in start to void, increase frequency, getting up in the night to void, urge to void etc. What is your PSA? What is your post void residual (PVR) urine measurement? Management of prostate enlargement requiresall the above information. If you have significant voiding symptoms which are bothersome then you may need medications like alpha-blockers (eg: Tamsulosin). Usually these medications are good and work in most people. Other medications like 5- alpha reductase inhibitor (eg: Finasteride or Dutasteride) can also be used in combination with alpha- blocker or alone. If your symptoms do not improve with these medications or come back after initial improvement or if you develop urinary retention or if your PVR continue to increase then you may require surgical intervention. You should be regularly followed and examined by an urologist for your prostate problems.


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