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Tackling Benign Prostate Hyperplasia, an unseen challenge among Malaysian men

KUALA LUMPUR: The prostate is a walnut-sized gland, a vital organ at the urinary bladder's base that produces fluid to protect and nourish sperms, while the muscles keep urine from leaking out.

However, as men age, this organ can cause issues, with one of the conditions being Benign Prostatic Hyperplasia (BPH) or prostate enlargement.

According to the National Health and Morbidity Survey (NHMS) 2019, about 16 per cent of men in Malaysia aged 40 and above have some degree of BPH and the number increases to 33 per cent in men aged 75 and above.

Consultant Urologist and Endourologist at Sunway Medical Centre, Sunway City, Dr Christopher Lee Kheng Siang, said that BPH is caused by non-cancerous enlargement of the prostate gland and can impact the quality of life for men due to bothersome urinary symptoms.

"BPH is an advancing ailment that in its early stages, may manifest as mild discomfort and inconvenience.

"If not addressed, it can progress to a severe condition known as acute urinary retention, where the urethra becomes fully obstructed, leading to an inability to urinate, posing a risk of kidney damage, urinary tract infections, and the formation of bladder stones," he said in a statement, in conjunction with the month of November that is dedicated to raising awareness about men's health issues.

The NHMS 2019 survey also reflects Dr Christopher's opinion, with three in five men with probable BPH having a poor quality of life and being dissatisfied with their urination experience .

Dr Christopher added that many men dismiss urinary symptoms as a natural part of ageing without realising those symptoms can indicate a medical condition that requires attention.

"If you have not had alcohol or excess liquid shortly before bed, you should not wake up to go to the bathroom," he said.

Frequent urination at nights, difficulty holding in urine, straining during urination, incomplete emptying or dribbling at the end of urination and urinary retention in severe cases of BPH are few of the additional symptoms identified by Dr Christopher.

He said patients who think they have or suspect they might have BPH, can answer the International Prostate Symptom Score (IPSS) by the World Health Organisation (WHO) to assess BPH symptoms and severity.

He added, men aged 40 and older with a family history of BPH, individuals with existing medical conditions like obesity, heart disease, circulatory issues, Type 2 diabetes, or lack of regular exercise, are all at a higher risk of developing the condition but there are effective ways to manage it, depending on severity.

As for mild symptoms, lifestyle modifications such as managing fluid intake and reducing caffeine and salt can help ease the conditions and for moderate symptoms, medications can help relax the prostate as well as urethra muscles or gradually reduce the prostate's size over time to make urine flow easily.

Meanwhile, for men with more severe BPH or those who do not respond to medications, can opt for several surgical procedures depending on severity.

The surgical treatment available for moderate to severe cases of BPF ranges from Transurethral Resection of the Prostate (TURP), water vapour therapy or microwave therapy, laser enucleation or Bipolar enucleation of the prostate and robotic prostatectomy.

Dr Christopher said, the robotic surgical method to treat severe cases of BPH involves small, one-centimetre incisions compared to traditional surgical methods and significantly minimises pain and hastens recovery.

He said, patients that go through the surgical procedure can resume their routines sooner than traditional surgical methods.

"Men should not suffer in silence, instead they should seek proper screening and treatment to return to their normal lifestyle. There's no need to accept urinary symptoms as an inevitable part of ageing as seeking help and understanding the available treatment options is wise and empowering," he said. --BERNAMA

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