Take a tour of Made.com founder’s chic London pad
Take a tour of Made.com founder’s chic London pad

IMAGE Interiors & Living

The benefits of batch cooking, from more time to more money
The benefits of batch cooking, from more time to more money

IMAGE

It’s time to learn your attachment style…and how it’s impacting your relationship
It’s time to learn your attachment style…and how it’s impacting your relationship

Mairead Heffron

Maisie Williams, Jennette McCurdy, Drew Barrymore and the plight of abusive parents
Maisie Williams, Jennette McCurdy, Drew Barrymore and the plight of abusive parents

Sarah Gill

Supper Club: This delicious French Onion Soup makes for a seriously tasty lunch
Supper Club: This delicious French Onion Soup makes for a seriously tasty lunch

Jennifer McShane

October Event Guide: Festivals of food, art, comedy, jazz, and all things Halloween are on the horizon
October Event Guide: Festivals of food, art, comedy, jazz, and all things Halloween are on...

Sarah Gill

Duvet Day: Sustainable Irish sleepwear brands to help you sleep well
Duvet Day: Sustainable Irish sleepwear brands to help you sleep well

Sarah Finnan

Member competition: WIN a six-week mentorship with the Mentor Her programme
Member competition: WIN a six-week mentorship with the Mentor Her programme

IMAGE

Does glycolic acid work as deodorant?
Does glycolic acid work as deodorant?

Holly O'Neill

Have you tried… the Wim Hof Method?
Have you tried… the Wim Hof Method?

Holly O'Neill

Image / Self / Health & Wellness

Ask the Doctor: ‘My husband suffers from an enlarged prostate. He’s on medication, but it seems to be becoming less effective. Is there anything else that can be done?’


By Sarah Gill
09th Aug 2022

Unsplash

Ask the Doctor: ‘My husband suffers from an enlarged prostate. He’s on medication, but it seems to be becoming less effective. Is there anything else that can be done?’

All your burning health questions answered by the professionals.

“My husband suffers from an enlarged prostate and is frequently up during the night to use the bathroom. He is on medication from his GP for this but it seems to be becoming less effective over the past few months. Is there anything else that could be done for him?”


prostate

Answer from Dr. Michel de Wildt, Consultant Urologist in Beacon Hospital. He is specialised in treating men with urinary symptoms due to an enlarged prostate.

Benign enlargement of the prostate (which encircles the peeing tube and can lead to restriction of urinary flow out of the bladder) can cause bothersome urinary symptoms that affect quality of life by interfering with normal daily activities and sleep patterns. It remains one of the most common conditions affecting aging men.

Initial treatment usually starts with medication. Over time however, most men will notice the medication to be less effective and seek a more definitive solution.

Historically a TURP (TransUrethral Resection of the Prostate), was considered the surgical treatment of choice. Although TURP is effective, side effects are common and mainly consist of bleeding during surgery and in the postoperative period. It usually takes 2 to 4 days before patients can be discharged after surgery. It can then take up to 6 weeks before the urine becomes completely clear. Sometimes severe bloody urine means a patient has to be re-admitted to hospital for additional treatment.

Furthermore, with TURP it is not always possible to remove the prostate obstruction completely. It may leave residual prostate tissue that can give rise to recurrent growth, usually after 8-10 years. These patients then present with recurrent urinary symptoms, sometimes even urinary retention and may need a second surgery.

Several alternatives to TURP have been tried in the last 25 years and treatments have come and gone. Not because they had more side effects than TURP, it was actually the opposite. In Ireland Rezum and Urolift are two of these less invasive treatment options that are available now. Unfortunately, the improvement and long-term effects appear to be limited and usually men will have to undergo surgery in time.

It has been shown that enucleation of the prostate (which completely removes the obstructive part of the prostate) has been the most beneficial surgical solution. There is now a novel surgical approach that actually achieves this with minimal side effects and significant shorter recovery time and hardly any blood loss during and after surgery.

This technique is called HoLEP ( Holmium Laser Enucleation of the Prostate). After HoLEP surgery, the majority of patients can have their (post-operative) bladder catheter removed the next day and they can be discharged. Usually, there are less complaints made in the first 6 weeks after this surgery compared with TURP. Long term results of HoLEP are also more permanent than after TURP.

When medication for urinary symptoms are not that effective anymore, this should be discussed with your GP. They can refer you to a urologist who can perform additional tests to see if surgical intervention like HoLEP is necessary.

Presently in Ireland, HoLEP is only offered in Beacon Hospital in Dublin.

Have a question for the professionals you’d like answered? Get in touch with [email protected] with the subject headline ‘Ask The Doctor’.