by bruno
(millbrae ca)

question

I being having enlarged prostate for several years. Got treatment with Flomax, continues with it at a present time. Undecided to have surgery;
I am an almost 82 yr old, is the surgery very risky?

Answer

Hello Mr Bruno,

The first thing we want you to know is that the choice whether you should undergo surgery for enlarged prostate or not is entirely your own. Reliable trials have concluded that even old men benefit significantly from a TURP procedure.
So, it is up to you to decide to continue taking Flomax, which is the most effective treatment for enlarged prostate, or to have surgery.

But, there are some absolute indications of enlarged prostate:

1. Chronic urinary retention-
2. Increased azotemia which is an indicator for kidney damage
3. Hydroureteronephrosis- which means the urine, unable to go out of the body, inundates ureters and the kidneys
4. Severe urinary symptoms
5. Post-void residue over 250 ml

Some of the doctors, include in the indications for prostate enlargement surgery even the following issues:

1. If the medical treatment fails
2. If the medical treatment does not have the results we expect.

If you find yourself in one of the aforementioned situations, then surgery for treating enlarged prostate is a must.
If you decide to undergo surgery, you have multiple options to choose from.

1. We do not recommend you to undergo open prostatectomy- It is very risky in your age and has numerous side effects.
2. TURP- Transurethral resection of the prostate may be an excellent choice. It has minimal blood loss, minimal stay at the hospital and minimal side effects.
3. TUMT-transurethral microwave thermotherapy- a new procedure which uses heat to destroy prostate tissue
4. TUNA- transurethral needle ablation. It Is a new thermal approach, which uses two needles to heat and kill prostate tissue
5. Hifu- high intensity focused ultrasound. It uses ultrasound to treat to destroy the excess prostate tissue
6. Prostate robotic surgery- or “Da Vinci” mechanism. This Is the newest approach in treating enlarged prostate, amongst other numerous conditions.

All the aforementioned techniques are safe using in elderly men. They have very few side effects, which makes them perfect for treating the enlarged prostate. It is your choice to decide to continue medical treatment or undergoing a surgical procedure.

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