Q: My grandfather is 90 years old. He is suffering from frequent urination for past 2-3 years for which he is taking homeopathy treatment. He has become very weak and does not feel hungry at all. We got his x-ray and ultrasound done and the report says: Calcification and enlargement of prostrate; advised prostatic biopsy; serum alkaline phosphatase is above 6000 (normal being 250). Is it advisable for him to go for prostrate removal surgery at this age, considering his weakness and inability to eat much? What is most suitable treatment for frequent urination? Is it OK to get the biopsy done at 90 years of age? What does a high value of alkaline phosphatase indicate? Is it related to prostrate enlargement or something else?

A:Decision to operate for prostate is not dependent on ultrasound pictures. Frequent urination represents an irritable bladder and does not indicate the need for surgery. Surgery has to be reserved for documented obstruction, which may be indicated by interrupted stream of urine, high residual urine and a poor flow. High alkaline phosphatase at this age may indicate bone disease or some deranged liver functions and has no bearing on prostate or its enlargement.