Prostate Surgery in Ahmedabad

What is the Prostate?

The prostate is a small, walnut-shaped gland located just below the urinary bladder in men. It surrounds the upper part of the urethra — the tube that carries urine from the bladder to the outside — and contributes fluid to the semen. As men age, the prostate often grows in size. When this enlargement presses on the urethra, it can gradually interfere with the normal flow of urine.

Because the prostate sits at the outlet of the bladder, even a modest increase in size can affect urination and, over time, the health of the bladder and kidneys. A timely evaluation helps determine whether the changes are due to a benign enlargement or another prostate-related condition.

Common Prostate Conditions

These conditions can produce overlapping symptoms, and evaluation by a doctor is important to determine the underlying cause and appropriate treatment.

Focus: Enlarged Prostate (BPH)

Benign prostatic hyperplasia is one of the most common conditions affecting older men. As the gland enlarges, it can partially obstruct the flow of urine, forcing the bladder to work harder. Over time, the bladder muscle may become irritable or, in advanced cases, less efficient. Not every man with an enlarged prostate needs surgery — treatment depends on symptom severity, bladder function and any related complications.

Symptoms

• Weak or interrupted urinary stream
• Straining to start or maintain urination
• Increased frequency of urination during the day
• Urgency — a sudden strong need to pass urine
• Nocturia — waking up at night to urinate
• Sensation of incomplete bladder emptying
• Dribbling at the end of urination
• In some cases, inability to pass urine (acute urinary retention)

When Symptoms Become Urgent

Causes and Risk Factors

The exact cause of BPH is not fully understood, but it is closely linked to ageing and hormonal changes. Common contributing factors include:

• Ageing — the risk rises noticeably after the age of 50
• Family history of prostate enlargement
• Hormonal changes over time (including changes in testosterone and related hormones)
• Metabolic factors such as obesity and diabetes may play a role
• Reduced physical activity in some cases

Diagnosis

Assessment usually begins with a detailed history of urinary symptoms and their impact on daily life. Common investigations may include:

• Clinical history and a symptom-score assessment
• Digital rectal examination (DRE) to assess prostate size and consistency
• Urine analysis to look for infection or blood
• PSA (prostate-specific antigen) blood test
• Ultrasound of the abdomen and pelvis to assess the bladder, kidneys and prostate size
• Uroflowmetry to measure the strength of the urinary stream
• Post-void residual urine measurement to check how much urine remains in the bladder after passing urine

Additional tests such as cystoscopy or specialised imaging may be advised depending on the patient's condition.

Treatment Options

Lifestyle and medical treatment

Many patients with mild to moderate symptoms can be managed initially with lifestyle adjustments and medication. This may include reducing evening fluid intake, limiting caffeine and alcohol, treating constipation, and reviewing medicines that may worsen urinary symptoms. Commonly used medicines include:

• Alpha-blockers — help relax the muscle at the bladder neck and prostate, often improving flow
• 5-alpha reductase inhibitors — may gradually reduce prostate size over months, particularly in larger glands
• Combination therapy in selected patients

When surgery is considered

Surgical treatment may be recommended when:

• Symptoms are poorly controlled despite adequate medical treatment
• There is repeated or persistent urinary retention
• Recurrent urinary tract infections related to obstruction
• Blood in the urine due to the prostate
• Bladder stones or kidney-related changes have developed

Surgical Options

TURP (Transurethral Resection of the Prostate)

TURP is one of the most commonly used surgical techniques for BPH. It is performed through the urethra using a specialised endoscopic instrument, so there is no external cut on the abdomen. The obstructing prostate tissue is trimmed away in small pieces, widening the urinary channel. A catheter is usually kept in place for a short period after surgery to allow the area to heal.

Other techniques

Depending on the size of the prostate and the patient's condition, additional options may be considered:

• Laser prostatectomy — uses laser energy to vaporise or enucleate prostate tissue in selected patients
• Open prostatectomy — may be considered for very large prostate glands where endoscopic techniques are less suitable

Prostate cancer surgery is a separate consideration and requires proper oncological evaluation, staging and planning, which may involve a multidisciplinary team.

Recovery

Recovery varies from patient to patient and depends on the technique used, the size of the prostate and general health. Most patients spend a short period in hospital, with a urinary catheter to allow healing. Some mild burning or urgency during urination is common in the early recovery period and usually improves gradually. Light activity is typically resumed within a few days, while strenuous work and heavy lifting usually require a longer break, as advised by the surgeon.

Follow-up

Regular follow-up helps monitor symptom improvement, urinary flow, and any change in prostate size or PSA level over time. Ongoing lifestyle measures, treatment of related conditions (such as diabetes) and periodic clinical review are important parts of long-term care.

Frequently Asked Questions