An enlarged prostate, also known as benign prostatic hyperplasia (BPH), is a common condition that affects men as they age. It can cause a variety of uncomfortable symptoms and can lead to serious health problems if left untreated. In this guide, we’ll discuss the basics of this ailment and the long-term outlook for those who undergo treatment. We’ll also answer common questions about enlarged prostate treatment in Singapore.

What is an Enlarged Prostate and What Causes It?

An enlarged prostate is a condition that affects men as they age. It is caused by an overgrowth of prostate cells in the gland. This causes the prostate to become enlarged, which can lead to various symptoms. The most common symptom is difficulty urinating, as the enlarged prostate can put pressure on the urethra and make it difficult to urinate. Other symptoms include:

1. A frequent need to urinate
2. A weak urine stream
3. Difficulty starting or stopping the flow of urine.
4. Dribbling or leaking urine
5. A feeling of incomplete bladder emptying
6. Waking up multiple times a night to urinate.

(https://www.gleneagles.com.sg/health-plus/article/benign-prostatic-hyperplasia)

The exact cause of an enlarged prostate is not known, but it is thought to be related to hormonal changes that occur with age. It is a common ailment of men in their later years and it is related to the changes in hormones which cause the prostate gland to grow [1].

Prevalence of Enlarged Prostate in Singapore

As of now, the prevalence of symptoms suggestive of an enlarged prostate is 39.5% of men aged 40 and older. Researchers conducted a systematic review of relevant publications on the prevalence of an enlarged prostate in Singapore. Their review includes a demographic breakdown of the prevalence records of different studies. The findings show that the incidence rate of an enlarged prostate increases with age in Singaporean men. It is also more common in Indian and Malay men compared to Chinese.

When to Seek Professional Help for an Enlarged Prostate

If you are experiencing any of the symptoms of an enlarged prostate, it is important to see a doctor as soon as possible. Your doctor will be able to help you determine the best treatment option for your particular situation. They may recommend lifestyle changes, medications, or other treatments to reduce the size of the prostate and improve the flow of urine.

What to Expect During an Enlarged Prostate Evaluation & Diagnosis

When you visit a doctor for an enlarged prostate evaluation, they will ask you about your symptoms and medical history. They will also perform a physical exam to check for any signs of an enlarged prostate. Your doctor may also order tests, such as a urine test, a prostate-specific antigen (PSA) test, or an imaging test, such as an ultrasound or a CT scan. A biopsy may occasionally be required if the imaging test shows any suspicious nodules.

Tips for Managing an Enlarged Prostate

In addition to medications, there are several lifestyle changes that can help manage an enlarged prostate. These include:

1. Avoiding caffeine and alcohol
2. Quitting smoking
3. Exercising regularly
4. Maintaining a healthy weight
5. It is also important to drink plenty of fluids

The Different Types of Enlarged Prostate Treatments

There are a variety of treatments available for an enlarged prostate. The type of treatment will depend on the severity of the symptoms and the underlying cause. Treatment options include medications, lifestyle changes, minimally invasive procedures, and surgery [1].

1.Medications are the most common treatment for an enlarged prostate and are usually the first line of treatment. These medications can help reduce the size of the prostate, reduce the symptoms, and improve the flow of urine. Common medications used to treat an enlarged prostate include alpha-blockers, 5-alpha-reductase inhibitors, and antimuscarinics [2].

2.Minimally invasive procedures are also used to treat an enlarged prostate. Prostate Artery Embolisation is a minimally invasive procedure that blocks arteries that make the prostate shrink. In this procedure, an incision or puncture is made in the groin. A catheter is inserted, and then tiny particles are injected into the catheter. This way, the urethra becomes less congested and the prostate shrinks.

(http://bocaradiology.com/men/pae.html)

3.Surgery is usually the last resort for an enlarged prostate, and there are several different types of surgery available. One type of surgery used to treat an enlarged prostate is transurethral resection of the prostate (TURP). This procedure involves removing part of the prostate through the urethra. Other types of surgery include open prostatectomy and laser prostatectomy.

(https://www.cancer.gov/publications/dictionaries/cancer-terms/def/turp)

What to Do After an Enlarged Prostate Treatment

Once you have completed your treatment for an enlarged prostate, it is important to take steps to maintain a healthy prostate. This includes following your doctor’s instructions, taking medications as prescribed, avoiding caffeine and alcohol, quitting smoking, exercising regularly, and maintaining a healthy weight. It is also important to follow up with your doctor regularly to ensure that your treatment is working.

The side effects of enlarged prostate treatments vary depending on the type of treatment. Common side effects of medications include dizziness and abnormal ejaculation. Side effects of minimally invasive procedures and surgery may include pain, bleeding, and infection. It is important to talk to your doctor if you experience any side effects [3].

How to Prepare for Enlarged Prostate Treatment

Before beginning treatment for an enlarged prostate, it is important to prepare. This includes talking to your doctor about any medications you are taking, quitting smoking, and avoiding caffeine and alcohol. It is also essential to follow your doctor’s instructions and ask any questions you may have about the treatment. Of particular importance is to inform your doctor if you are on any blood-thinning medications, as this may need to be discontinued during and after the surgery to prevent excessive blood loss.

Expectations and Maintenance After Enlarged Prostate Treatment

After an enlarged prostate treatment, it is important to take steps to maintain a healthy prostate. This includes following your doctor’s instructions in preparing for your overall lifestyle.  It may be wise to keep a list of previous medications, medical tests, and other pertinent information.

Minimally invasive procedures offer a quick return to daily activities, minimal discomfort, and same-day discharge from the facility. On the other hand, open surgery methods usually require patients to be confined in the facility for proper monitoring. It is also important to follow up with your doctor regularly to ensure that your treatment is working.

Understanding the Long-Term Outlook for Enlarged Prostate Treatment

The long-term outlook for enlarged prostate treatment depends on the type of treatment. Medications can help reduce the symptoms and improve the flow of urine but may not be effective in all cases. Minimally invasive procedures and surgery can be more effective but may come with risks and side effects. Following up with your doctor regularly is important to ensure your treatment is working. Regular check-ups may be needed to monitor the recovery progress.

Choosing a Specialist

Selecting a specialist for BPH treatment in Singapore may be challenging due to the diversity of the options available. The healthcare provider’s qualifications and experience are both important factors to remember before making a decision. A professional doctor’s background might be verified using various tools. It’s easier to turn to a doctor who has experience managing BPH-related illnesses. Taking a closer look at a physician’s website is also a good way to get a sense of their skills. It provides a chance to see patient evaluations and gain a better understanding of the provider’s experience. Choose a healthcare provider that has your concerns in mind and is prepared to provide the attention and care you want. When selecting a healthcare professional, a provider’s interpersonal skills, the possibility of a second opinion, and personal beliefs and concerns about care should all be considered.

Today, numerous professionals, including urologists, radiation oncologists, and medical oncologists, work with multidisciplinary groups to treat BPH. The nature of the treatment team a physician works with determines the care available to patients. It’s difficult to locate or obtain the doctor’s qualifications without asking questions throughout meetings and consultations. It’s essential to gather as much information as possible about the doctor’s treatment approach to see how it aligns with one’s own values and expectations. Patients must choose a doctor who can offer the care they want and whose approach to care they trust. Provide people with advice on how to approach doctor consultations and visits. Patients should ask plenty of questions, whether they’re meeting a sole practitioner or a team of physicians working with a multidisciplinary panel. Their healthcare provider should also be able to provide them with the information they need.

It’s a good idea to seek advice from reliable friends, family, or primary care physicians who are familiar with the healthcare provider. They might be more likely to offer a more complete picture of the provider and provide insight into the physician’s relationships with patients. Second opinions are frequently sought by patients. They should not be afraid to seek advice from someone who may be more familiar with their medical situation. Find the most suitable care choices. Mandatory proven care treatments are not provided by the majority of doctors. They will typically provide various care options, and patients can discuss the risk-benefits process with them and achieve a total understanding before they begin.

Qualifications and Experience

It is crucial to see a trained urologist or urology surgeon with the proper experience in managing an enlarged prostate. A locally recognized medical degree, as well as registration with or accreditation from the Ministry of Health, is required for a urologist specializing in treating enlarged prostate in Singapore. Specialists who are senior and experienced in the field of urology are certified by the relevant medical authorities. Check to see if they have a higher degree or fellowship from a reputable institution.

The number of procedures and interventions performed can give you an indication of how skilled a specialist is. You might also ask about their track record and overall patient satisfaction. If they write frequently about new surgical procedures or treatments, they may be at the leading edge of enlarged prostate management. Medical training is, as a result, essential. Look for a medical institution that offers fellowships in a specific area, or ask the specialist about their expertise in the subject. Examinations, where therapists from other countries assess a specialist physician, can also provide a level of competence. Other boards may require intensive training and a barrier test, making certain requirements must be met. A fellow who has completed their fellowship can present their particular expertise in the treatment of enlarged prostate.

Lifestyle and Preventive Measures

You have options for preventing or reducing the severity of your enlarged prostate symptoms. Screening is important to keep track of any changes in your health. It is advisable for all adults to engage in regular check-ups at least once a year with a healthcare professional, even if you are feeling healthy. Here are 16 lifestyle and home remedies to help you manage and improve an enlarged prostate. If you have BPH symptoms, working in partnership with your healthcare team to incorporate these and other lifestyle practices can often be beneficial.

1. Manage Stress

2. Maintain a Balanced Diet

3. Exercise Regularly

4. Go When You Need To

5. Avoid Caffeine and Alcohol

6. Get Warm

7. Stay Dry

8. Medications

9. Urinate Before You Leave the House

10. Use Pads and Catheters

Some men will require or choose to use catheters to help with urinary incontinence and other lower urinary tract symptoms not corresponding to BPH. It has to be prescribed and used according to specific instructions from a healthcare provider, and it may involve a combination of self-intermittent catheterization, an external catheter, and a condom catheter, for example.

Choosing the Right Solutions

Everyone can do their part to prevent BPH while managing and controlling symptoms that might already be present. Even though there is no way to prevent aging and the levels of testosterone men have, changing your lifestyle and making good choices in terms of behavior can help you control non-cancerous growths that come with aging. Generally, most activities and habits that promote a healthy lifestyle should also help prevent BPH. Getting regular screenings can help prevent any very small enlargement of the prostate and prevent possible complications that might develop later. Men are advised to consult with a doctor to determine the right time to start screening for age.

Dietary Recommendations

Diet plays a critical role in managing prostatic hypertrophy. Notwithstanding the limited evidence on the causative factors for benign prostatic hypertrophy, there are potential nutritional strategies that have been recommended. A balanced diet that is full of fresh fruits, vegetables, legumes, seeds, nuts, whole grains, and fortified cereals will provide the essential nutrients to help manage BPH and its symptoms. Lycopene found in tomatoes may have a protective effect on the prostate, as well as cruciferous vegetables such as broccoli, kale, and Brussels sprouts. Beta-sitosterol, selenium, vitamin C, and essential fatty acids found in omega-3 and omega-6 are also beneficial to the prostate. This can be found in sunflower oil, canola oil, sesame oil, and olive oil. Quercetin-rich foods, which are antioxidants, can also be taken in a variety of fruits such as apples, berries, cherries, and red grapes. Although these components only reduce the symptoms of BPH, they are still beneficial to the overall health of a man as part of a general healthy eating routine. The proportion of these nutrients that a man should be eating is still unclear. Red meat and processed foods should be limited, particularly cheese and salty foods. Processed foods such as bread, commercial dressings, and pizza should be limited as they raise the acidity of the urine.

Patients with nocturia should not consume fluids right before going to bed and should try to spread fluid intake throughout the day, commencing with higher fluid intake during breakfast and lunch and reducing it at dinner. If possible, he should take his first dose not at bedtime but in the late afternoon. A regular diet full of fresh fruits, vegetables, legumes, seeds, nuts, whole grains, fortified cereals, and lean protein sources, moderate portions of healthy fats, and very little consumption of salt, saturated fats, and added sugars are essential. A man should also concentrate on the following food choices as part of a healthy diet:

• Eat 5-10 servings of fruits and vegetables every day, and 1-2 pieces of fruit. Acids found in fruits and vegetables, such as ascorbic, malic, and citric acid, can alkalinize urine, reducing irritation from resorbed ammonia in urine and bladder.

• Eat healthy fats, such as those found in flaxseed and omega-3-rich foods.

• Eat at least 3 to 4 servings of whole grain products, such as barley, oats, amaranth, quinoa, millet, brown rice, bread, pasta, and cereals.

Fruits and vegetables are important because they are a rich source of vitamins, minerals, and phytonutrients, which can help protect and nourish the prostate. These include foods rich in vitamin C, such as citrus fruits, tomatoes, broccoli, kiwi, and capsicum. Send the patient to a dietitian for personalized advice that can be tailored to their overall and individual nutritional needs. Remember that the optimal macronutrient intake for benign prostatic hypertrophy is not known, but the evidence does suggest that a higher intake of healthy fats relative to the total macronutrient intake may be beneficial. Ensure all dietary advice is evidence-based and is best practice from a nutritional and urological perspective.

Physical Activity and Exercise

Regular physical activity and exercise are important for our overall health. Exercise can help both enlarged prostate symptoms and sleep quality. You can choose a suitable mechanism that can break down easy exercises during the day. If you are too busy, take the time to stretch your muscles in just 5 minutes. Walking on a flat road for 60 minutes a day also brings many benefits to your health. Exercise not only helps you prevent prostatic hyperplasia but also prevents diseases such as erectile dysfunction, diabetes, obesity, and many more. Exercise increases the body’s vascular capacity, reducing the risk of hypertension and helping the muscles around the uterus improve blood flow. Strengthening the muscles around the uterus will help reduce the pressure on the bladder and ureter, reducing the symptoms of frequent urination, difficult urination, and prostate hyperplasia. Aerobic exercises are good for the cardiovascular system. Some examples include brisk walking, swimming, cycling, jogging, and dancing. Include aerobic exercises in your workout plan most days of the week. Strength training exercises make your muscles stronger. Some examples include using weight machines or lifting free weights. Strength training on two or more days per week is recommended. Exercising regularly will help your energy and endurance levels. It helps blood circulation and helps hormones work better. Exercise is also a natural stress reducer. It helps you relax and eliminates anxiety. Tailor your exercise to your fitness level and overall health status, and choose something you enjoy. Start slowly and work your way up to more activities. It is important to find the right balance to avoid doing too much.

FAQs

References

[1] https://www.sgvascularctr.com/service/enlarged-prostate/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213889/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225336/

Dr Chen Min Qi profile

Dr. Chen Min Qi is a fellowship-trained Vascular and Endovascular Surgeon who graduated from the National University of Singapore in 2005. He subsequently completed his basic and advanced training in General and Vascular Surgery while obtaining the Member of Royal College of Surgeons of Edinburgh (MRCSed) qualification in 2010, and the Master of Medicine (General Surgery) qualification in 2015. Dr Chen was subsequently successful at the fellowship exams obtaining the Fellow of Royal College of Surgeons of Edinburgh (FRCSed) qualification in 2016.

Upon completion of his advanced surgical training, Dr Chen Min Qi joined the newly opened Ng Teng Fong General Hospital (NTFGH) as a specialist in the Vascular Surgery division. In 2018, Dr Chen was awarded the Health Manpower Development Plan (HMDP) grant from MOH to undergo further subspeciality Vascular training at the internationally renowned St Mary’s Hospital in London, United Kingdom. There Dr Chen gained further experience in surgeries on complex abdominal and thoracoabdominal aortic aneurysms, redo open repair of abdominal aortic aneurysms following failed EVAR surgeries as well as carotid endarterectomy surgery and lower limb revascularization surgeries.

Upon his return in 2020, Dr Chen Min Qi joined the newly formed Woodlands Health as head of their Vascular service, before joining his current practice at the Vascular and Interventional Centre in January 2023.