Prostatic diseases

Problems emptying the bladder without difficulty are one of the most common diseases in men and, although they are generally not severe, they may cause a significant deterioration in the quality of life, making it difficult to have a normal life. With proper management, using the proper diagnostic techniques and the most advanced treatments offered from this medical office, symptoms may not only improve, but we are able to prevent future severe problems.

No. It is a completely benign process.

Although one of the most common causes for problems for urination is BPH, it is not always the only or the main cause. Emptying the bladder involves other organs than the prostate such as the bladder, the sphincter or the urethra (the tube through which urine flows), plus all these organs must be coordinated. Therefore, nowadays the symptoms for urination previously named “prostatic hyperplasia” or “BPH”, are now called “Lower Urinary Tract Symptoms” or LUTS, given the high frequency in which other organs other than the prostate are involved.

There may be difficulty in emptying the bladder resulting in a slow stream, and even in the need to stop and start several times, dripping after finishing urination, difficulty starting the voiding, especially after waking up, and the feeling of incomplete emptying of the bladder. It can also cause the patient to get up at night to urinate and the presence of urgency or overriding need, that is, the patient has to go “running” to the toilet because he cannot resist the urge, incontinence and the need to urinate every few hours. In severe cases it may cause bladder stones, bleeding in the urine or inability to urinate which is usually remedied with a bladder catheter.

There are different causes. There are patients whose bladders do not contract properly and therefore there isn’t enough pressure to release the urine; this problem is called hypotonic bladder. It may also be involuntary bladder contractions which may cause urine leakage and incontinence, and this is called hyperreflexic bladder. There might be strictures in the urethra, the tube through which urine flows, and therefore difficulty emptying the bladder. Another reason for poor quality of urination is the absence of an adequate coordination of the bladder, prostate and sphincter and so the voiding is not synchronized; which is called dysynergy.

To prescribe the most effective treatment, it is essential to make a proper diagnosis beforehand, spending time with each patient to determine the cause of the problem. Only after detecting the cause or causes of the symptoms, a specific treatment for that problem can be started. There are various treatments, but there are two main groups: drugs and surgery.

There are several drugs. The drug prescribed should be personalized depending on the severity of symptoms, the characteristics of the prostate and bladder, and the patient’s condition and preferences. It is inappropriate to use the same treatment for all patients.

There are several techniques, but basically it involves removing the part of the prostate that has grown with age and that is causing problems. These techniques are usually endoscopic, ie, minimally invasive, and are performed through the urethra or urine conduit (transurethral). The patient may go home urinating successfully a few days after surgery. The type of technique used must be personalized, since there is no endoscopic technique that fits all cases. From this clinic, we offer wide experience in surgery of this disease, using the most advanced surgical techniques to provide the best results in every case.