The symptoms of benign prostate enlargement or hyperplasia (BPH) are multiple and varied. Different types of urinary urgency are common.

• Difficulty emptying the bladder completely.
• Need to urinate more frequently, especially during night time.
• Interrupted urination.
• Urinary incontinence and urinary urgency.

Before your outpatient visit at the clinic you will be asked to fill out a questionnaire about your symptoms. You can also be asked to keep a diary of your fluid intake and urinary volumes during a two day period.

Ruling out cancer

It’s standard procedure to perform a blood test to check PSA levels. This is done to rule out cancer. At Peritus Clinic we recommend an MRI as the initial step in the diagnosis. If the MRI shows signs of suspected cancer the next step is a fusion biopsy of relevant prostatic tissue.

Our biopsy technique, combining MRI of the prostate with an ultrasound examination, is considered optimal to rule out or diagnose prostate cancer. Tissue biopsies are obtained by directed punctures through the skin between the scrotum and the anal opening. By avoiding traditional transrectal biopsies, the risk of postpuncture septicemia is reduced from 5 to 10 % to almost zero.

Cystoscopy

A cystoscopy is a procedure to look inside the bladder using a thin flexible endoscope  (cystoscope). The cystoscope is introduced through the urethra and passed into the bladder to help decide whether further tests are needed. The procedure can most often be performed under local anaesthesia.

Cystometry
Cystometry is a test used to look for problems with the filling and emptying of the bladder. The bladder is a hollow muscular organ that relaxes and expands to store urine. Cystometry measures the amount of urine in the bladder and if there are any obstacles that obstruct the urine flow. A thin tube is inserted through the urethra to the urinary bladder. At the Peritus Clinic we use the latest cystometry equipment.

CT scan
If the urologist suspects that your kidneys are affected, a CT scan (CT urography) can be performed to obtain further information about possible diseases in the urinary tract.

Benign prostate enlargement negatively impacts the quality of life. If not treated in time there’s a risk of complications in other organs, primarily the urethra and in rare cases the kidneys.

When the initial tests and examinations have been performed pharmaceutical treatment can be a solution, but in some instances surgery is recommended.

Pharmaceutical treatment

A number of drugs are used to treat the symptoms of BPH and hyperactive bladder conditions. Prazosin and finasteride are the two most common to improve the urinary flow. In some cases bladder contractions need to be suppressed. All the drugs need to be taken on a regular basis to have optimal effect. You will be informed of possible side effects.

Transurethral resection of the prostate (TURP) 

Transurethral resection of the prostate (TURP). Tissue is resected from the prostate using a resectoscope (a thin, lighted tube with a cutting tool at the end) inserted through the urethra. Prostate tissue that is blocking the urethra is cut away and removed through the resectoscope. General or spinal anaesthesia is used during the procedure so you don’t feel any pain while it’s carried out.

The method is effective but there is, however, a risk of bleeding and you usually need to be hospitalised for 1-2 days. Minor procedures don’t require hospitalisation but you should expect to wear a urinary catheter for 1-2 days after surgery.

Thulium laser

Peritus Clinic is the first hospital in Sweden to offer the latest laser technology to treat BPH. Thulium laser is used as an alternative to traditional TURP. It’s basically the same procedure, only a laser is used to remove the enlargement instead of the resectoscope. The laser technology ensures excellent surgical control and minimizes bleeding.

Usually you can leave the hospital without a catheter the day after the surgery and in some cases the same day.

Preparations

Before the procedure you will meet with our anaesthetist to discuss the need for anaesthesia. You will be fasting from midnight and arrive at the clinic in the morning on the day of your surgery. You will receive a calling with enclosed instructions on preparations well in advance of the surgery.