Prostate Size: When to Consider Surgical Treatment

Mike is a 60-year-old man with acute urinary retention due to excessive alcohol consumption. After being catheterized at a local hospital, he was recommended for surgery due to severe urinary tract obstruction. However, Mike refused to undergo surgery and sought treatment at another hospital. 

Upon examination, his prostate measured 45 x 35.5 x 34 mm, which was larger than the standard size of 40 x 30 x 20 mm. However, it was determined that Mike's prostate was not large compared to the standard size for a man over 45 years of age. Therefore, surgery on Mike's prostate was not recommended.

Surgical treatment is an effective method for an enlarged prostate, but not all enlarged prostate requires surgical treatment.

So, how big is the prostate necessary to consider surgical treatment?

I. Necessity of Surgical Treatment of the Prostate

When is Prostate Surgery Considered Necessary?

Prostate surgery is commonly used to treat diseases such as prostatic hyperplasia and prostate cancer. For prostatic hyperplasia, surgical treatment should be considered when symptoms affect the patient's quality of life, such as frequent urination, urinary urgency, painful urination, nocturia, and other symptoms that seriously affect the patient's daily life. For prostate cancer, surgery is usually the first choice of treatment.

Why is Prostate Surgery Needed?

Prostate surgery can effectively relieve the symptoms and dangers caused by diseases such as prostatic hyperplasia and prostate cancer. For BPH symptoms, surgical treatment can alleviate problems such as difficulties in urination, urinary retention, and urinary tract infections, thereby improving the patient's quality of life. In the case of prostate cancer, surgical treatment can completely remove the patient's cancerous tissue, then increasing the cure rates and preventing the spread of cancer.

II. Prostate Disease Can Lead to Urinary Tract Obstruction, Which is Categorized in the Following Three Ways:

1. Dynamic Obstruction: the volume of the prostate increases and presses on the bladder and ureter, resulting in symptoms such as slowed urine flow, decreased urine output, and urinary tract obstruction. In this case, surgery is a more effective treatment.

2. Obstructive Urinary Tract Infection: Urinary tract obstruction caused by prostate disease may cause urinary tract infection, resulting in frequent urination, urgency, pain, and other symptoms. Antibiotic therapy is the conventional treatment, but surgical treatment may also be necessary when indicated.

3. Neurogenic Urinary Retention: Prostate disease may also damage the nerves of the bladder, causing the bladder to fail to empty adequately and causing symptoms such as urinary retention. In this case, a urinary catheter or surgical treatment is usually required to relieve the symptoms of urinary retention.

III. Effect of Prostate Size on Surgical Treatment

A. Standard Prostate Size. The standard prostate size is 40 x 30 x 20 mm; the prostate size that is outside the standard range is usually considered to be an enlarged prostate.

B. Effect of an Enlarged Prostate on Surgical Treatment. An enlarged prostate can lead to symptoms such as weaker urine flow, frequent urination, urgency, painful urination, and urinary retention, but not all enlarged prostate require surgical treatment. The necessity for surgical treatment depends mainly on the severity of symptoms. Typically, surgical treatment is required when the prostate is enlarged by more than 60ml or causes urinary tract obstruction.

C. Effect of Prostate Shrinkage on Surgical Treatment. A shrinking prostate usually does not require surgical treatment as it is often the opposite of the symptoms of an enlarged prostate. A shrinking prostate may cause symptoms such as excessive urine flow or dysuria, but these problems can usually be resolved with medical therapy.

IV. Other Factors Affecting Surgical Treatment of the Prostate

The severity of symptoms: The necessity of surgical treatment of the prostate depends mainly on the severity of the patient's symptoms, such as dysuria, urinary retention, urinary frequency, urinary urgency, nocturia, and other symptoms.

Age: Age is also a factor affecting the surgical treatment of the prostate. For older patients, surgical treatment may pose greater risks, so the necessity and risks of surgical treatment need to be carefully considered.

Health status: The patient's health status can also affect the decision regarding prostate surgical treatment. For example, if the patient has heart disease, lung disease, hypertension, etc., surgical treatment may increase the surgical risk. Therefore, it is necessary to comprehensively consider the health status of the patient to determine whether to perform surgical treatment.

You may also be interested in:

Increased Prostate Size: Don't Worry Too Much

Prostate: the 'Trouble Zone' for Men's Health

5 Kinds of Exercises to Enhance Prostate Function, Let's Learn It!