Source: Medical Channel Asia
Video Transcript:
Waking up in the middle of the night to pee, or often finding yourself having to empty your bladder regularly. If you are a man facing such issues, you might be suffering from benign prostatic hyperplasia or commonly known as BPH. And we’re here to talk about it today.
We have invited our very special guest, Dr. Ronny Tan. Hi Adam. Hi, I’m Dr. Ronny Tan. I’m a consultant urologist in private practice.My practice is called Advanced Urology and I run my clinics in Mount Elizabeth Hospital as well as Parkway East Hospital.
I have a few questions with regards to BPH, which my relatives has asked me. So, I hope you are able to help me clarify them. Yeah, sure.
So, Dr. Ronny, is it true that only elderly men get BPH?
Um, that may not be true because we know that, uh, every man has a prostate and it increases in size as BPH. So the Ballpark figure we take will be about the age of 50, 50% of men aged 50 will have a large prostate. It can increase up to about 80% in patients reaching the age of 80.
Is it true that prostate screening is only for those with enlarged prostates?
That’s not true because every man has a prostate. As you grow older, the prostate increases in size. So the thing that we will tell our patients will be whether they have a family history of prostate cancer. Those with a family history of prostate cancer should get it checked earlier, probably in the age of 40 to 45s. Those without prostate cancer at least should start screening their prostate at age 50.
So, doctor, what are the tests available?
Okay, when you come to the urologist clinic, we will do a physical examination as well as investigations. So a physical examination will entail digital rectal examination, basically what I will be doing. I’ll be using a gloved finger with lubricant to lubricate and put it up the rectum to feel for the prostate. That will allow me to feel how big the prostate is, the consistency, as well as whether any hard nodules suggest prostate cancer. Other tests that we do will be urine tests. One urine test will be done to look for infection in the blood and urine, a special urine test called uroflow, which will be able to assess how fast a man can pass urine. Other tests will include ultrasounds. I will do the ultrasound of the urinary tract, namely the kidney, the bladder, as well as the prostate itself. And then the other test that we do will be a blood test.
Why call it a tumour marker?
The common tumour marker that we will use is PSA. Sometimes PSA is also offered in the health screening packages that the GP will provide.
Doctor, is it okay to let my prostate grow as long as I can still endure the symptoms?
The enlargement of the prostate doesn’t do anything to itself. It affects the bladder, which is why you have symptoms like urinary symptoms. So if you leave it alone, what happens is you can have complications that will occur in the bladder. For example, infections, the patient can develop bladder stones. In the worst scenario, the bladder can fail. And should the bladder fail, there’s always a risk that the kidneys will fail because of the bladder failure. So, of course, the size alone is not the main issue. Of course, size does better. But the key will be whether this prostate obstructs the bladder, resulting in the complications that I mentioned earlier. So, should you have symptoms, it’s not good to just let it grow. You should always seek help from a urologist.
It’s BPH surgery painful? Because I heard that it cuts, it burns your prostate.
Also, it’s kind of scary for the general public to hear about it. As urologists, we use a lot of techniques to try to reduce the size of the prostate. You are right. We have use electricity to cut the prostate， We use laser to melt the prostate and also other numerous surgical techniques that we have used, including water vapor， We have used microwave, and then, there’s also another treatment where the prostate is not being destroyed what is why I call Prosthetic Urethral Lift. These three are known as the minimally invasive techniques.
So for the procedure Prosthatic Urethral Lift, basically there’s no destruction of the prosthatic tissue. So you can imagine, for example, if your prostate is like a curtain, there’s actually blocking, what we do is actually we pull the curtains apart and then we tie it up with curtain ties. So this will allow instead of light coming out, but now we have more urine coming out from the bladder.
So, how long does this procedure take to recover?
Most patients who undergo Prostatic Urethral Lift surgery, they will either stay overnight or even be discharged on the same day. Some patients go home without a catheter, and most just keep the catheter overnight. So I will say that a lot these patients who undergo Prosthetic Urethral Lift can resume their activities, maybe the following day or, or the day after.
So BPH surgery is not scary！ Thank you, Dr. Ron, for clearing our doubts today.
So if you do find this video useful, make sure to share it with loved ones. If you find that you experience some of the symptoms in terms of urinary symptoms, or if you are generally worried about your prostate health, feel free to reach out to a urologist.
半夜醒来小便，或者经常发现自己必须定期排尿。如果你是一个面临这些问题的男人，你可能患有良性前列腺增生或通常被称为BPH。我们今天就来谈谈这个。
我们邀请了非常特别的嘉宾，陈万伟医生。你好,亚当。你好，我是陈万伟医生。我是私人诊所的泌尿科顾问医生。我看诊的诊所是先进泌尿外科，我在伊丽莎白山医院和百汇东岸医院都有诊所。
我有几个关于良性前列腺增生的问题，我的亲戚问过我。所以，我希望你能帮助我澄清它们。是的,当然。
陈医生，真的只有老年男性才会患前列腺增生症吗？
这可能不是真的，因为我们知道，每个男人都有前列腺它会随着前列腺增生而增大。所以大概是50岁左右，50岁的男性中有50%的前列腺很大。在80岁以上的患者中，其发病率可达80%左右。
前列腺筛查真的只针对前列腺肥大的人吗？
这不是真的，因为每个男人都有前列腺。随着年龄的增长，前列腺也会增大。所以我们会告诉病人的是，他们是否有前列腺癌的家族史。那些有前列腺癌家族史的人应该更早检查，可能在40到45岁。那些没有患前列腺癌的人至少应该在50岁时开始进行前列腺筛查。
陈医生，有什么测试方法？
您到泌尿科门诊时，我们会给您做体格检查和调查。所以体格检查包括直肠指检，基本上就是我要做的。我会用一根带润滑剂和手套的手指来检测，把它放在直肠里去感受前列腺。这样我就能感觉到前列腺的大小，硬度，以及是否有硬结节提示前列腺癌。我们做的其他测试包括尿检。一项尿液测试将用于检查血液和尿液中的感染情况，这是一种被称为尿流率的特殊尿液测试，它将能够评估一个人排尿的速度。其他检查包括超声检查。我会做泌尿道的超声检查，也就是肾脏，膀胱，以及前列腺本身。我们要做的另一个测试是血液测试。
为什么称它为肿瘤标记物？
我们常用的肿瘤标记物是PSA。有时，家庭医生提供的全面健康检查也提供PSA。
医生，只要我还能忍受这些症状，可以让我的前列腺生长吗？
前列腺的增大对自身没有任何影响。但它会影响膀胱，所以你会出现泌尿系统症状。所以如果你不管它，发生的是你可能会有其他的膀胱并发症。例如，尿道感染，病人也可能发展成膀胱结石。在最坏的情况下，膀胱丧失功能。如果膀胱衰竭，就会有肾脏因膀胱衰竭而功能衰竭的风险。所以，当然，大小本身并不是主要问题。关键是前列腺是否会阻塞膀胱，导致我之前提到的并发症。所以，如果你有症状，就让它继续生长是不好的。你应该经常寻求泌尿科医生的帮助。
前列腺增生手术疼吗？因为我听说它会使用割、或者烧来治疗你的前列腺。
对于大部分人来说，听到这个消息也有点可怕。作为泌尿科医生，我们会用很多方法来缩小前列腺的体积。你说得对。我们使用电来切割前列腺，我们使用激光来融化前列腺，我们还使用了其他许多外科技术，包括水蒸气，我们使用微波，还有另一种治疗方法，前列腺不会被破坏，这就是为什么我称之为前列腺尿道提举术。这三种技术被称为微创技术。
对于前列腺尿道提举术来说，基本上没有对修复组织产生破坏。你可以想象一下，例如，如果你的前列腺就像一个帘子，这里有障碍物，我们要做的就是把帘子拉开然后用绳子绑起来。所以这将允许光照射进来（引用），但现在我们有更多的尿液从膀胱出来。
这个手术需要多长时间才能恢复？
大多数接受前列腺尿道提升手术的患者，要么会在这里过夜，要么甚至会在当天出院。有些病人回家时没有带导尿管，大多数人只是带着导尿管过夜。我想说的是很多接受尿道假体提升术的病人可以恢复他们的活动，可能在第二天，或者后天。
所以BPH手术并不可怕！谢谢你，罗恩医生，今天消除了我们的疑虑。
所以如果你觉得这个视频有用，一定要和你爱的人分享。如果你发现你有一些泌尿系统的症状，或者如果你普遍担心你的前列腺健康，请随时联系泌尿科医生。