Suggest Treatment For Enlarged Prostate And Hypertension

Posted on Fri, 28 Nov 2014

Question: sir my father is 74 year old and please see the reports and suggest me what i need to do in this regards

Answered by Dr. Rakesh Madhyastha (8 minutes later)

Brief Answer:
Hypertension and BPH

Detailed Answer:
Hello

Thanks for the query

It looks like your father has an enlarged prostate which required surgical correction which has been deferred in view of an hypertensive heart and also diastolic dysfunction. Which means that your father stands a high risk of going in for a heart failure either during or after surgery.

This is how you should go about it

1. Get a cardiology opinion and go for an angiogram to rule out any blocks in the arteries supplying the heart
2. If there are blocks in the arteries then it might require stenting
3. Once this is done, I strongly suggest that be goes for laser prostatectomy instead of conventional TURP. THis requires lesser anesthetia and post operative recovery is faster. Please enquire about this with your urologist

I also suggest you to attach the ultra sound abdomen with post void urine for me to see if he can be managed medically.

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (12 minutes later)

sir in attachment of XXXXXXX I have already attached Abdominal ultrasound report
on the basis of this our dr is not suggesting for the any kind of operation and he said that dont operate until and unless its highly essential and they have discharge my father from XXXXXXX Hospital XXXXXXX
In discharge card they have given 4 tablets and said for the reexamination after 7 days
sir let me know that what i need to do in this regards let me know your openinain and probable side effects after post operation if we go and problems if we not operate harnia
what you suggest can we go for medicine or operation

Answered by Dr. Rakesh Madhyastha (8 minutes later)

Brief Answer:
USG abdomen

Detailed Answer:
Hello

I have gone through the USG abdomen and it has only says that urinary bladder is distended. There is no comment on what is the amount of urine left over in the bladder after voiding the urine. This information is crucial, as significant post void urine is essential to know whether or not he will require operation. Also stagnant urine in the bladder will lead to recurrent urinary tract infections.

Your doctor has put your dad on medications to help better voiding of urine which will take about 1 week to show some effects, they will probably re assess him once again.

You will need to undergo this operation if it is absolutely required.
The common side effects are
1. Blood in urine
2. Recurrence of the prostate hypertrophy
3. Very rarely loss of bladder control

Hernia operation can wait at this point, it is absolutely required if the hernia is causing obstruction of the internal structures or painful.

I hope I was of help

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (14 minutes later)

sir, my father is not having any pain due to the harnia and as per the urologist of XXXXXXX hospital flow rate is normal and they have also made observation of urine for 24 hours it was around 2.3 Lits.
Sir so what i need to do shall i wait for one week and continue with current prescriptions made by Dr. XXXXXXX or i can go for another dr.
as these dr. having medical history and giving diagnosis from last three years
sir let me know that what i need to do

Answered by Dr. Rakesh Madhyastha (3 hours later)

Brief Answer:
Wait and see

Detailed Answer:
Hello

Thanks for getting

I strongly suggest that you wait for a week and see for improvement. Most of the times we see good improvement and bladder emptying capacity after taking tablets.

I hope I was of help

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar