Ghatkopar (East), Mumbai)
Enlarged Prostate - BPH Treatment in Mumbai
Waking up three times a night to use the bathroom. Standing at the urinal and waiting. The frustrating sensation of incomplete bladder emptying. These are the realities of benign prostatic hyperplasia – a condition that affects the majority of men over 50, yet one that millions continue to live with unnecessarily.
At Shree Hospitals, our urology team offers evidence-based enlarged prostate treatment in Mumbai, from lifestyle advice and medical therapy through to the latest minimally invasive surgical procedures - restoring normal urination and quality of life.
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Our Approach
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Our Approach In Managing Enlarged Prostate (BPH)
Better nights. Better days. Better flow.
BPH is a progressive condition - and treatment should be matched to the severity of symptoms and the patient's personal priorities. Our approach is stepped: we start conservatively and escalate only when symptoms warrant it or when the bladder is at risk.
- Symptom Assessment & Baseline Evaluation
Every BPH workup begins with objective symptom quantification:
- International Prostate Symptom Score (IPSS) - standardised questionnaire rating storage and voiding symptoms
- Uroflowmetry - measures urine flow rate and voiding time; normal peak flow >15ml/sec
- Post-void residual (PVR) urine - ultrasound assessment of incomplete bladder emptying
- PSA, renal function, and urinalysis to exclude prostate cancer and upper tract involvement
- Lifestyle Modification & Watchful Waiting
For mild symptoms (IPSS <8) without bladder compromise:
- Timed voiding - structured urination schedule to reduce urgency and nocturia
- Fluid reduction in the 2–3 hours before bedtime - particularly caffeine and alcohol
- Bladder training techniques to increase bladder capacity and reduce urgency
- Monitoring programme with repeat IPSS and uroflowmetry every 6–12 months
- Medical Management - Alpha-Blockers & 5-Alpha Reductase Inhibitors
First-line pharmacotherapy for moderate BPH (IPSS 8–19):
- Alpha-blockers (tamsulosin, silodosin) - relax smooth muscle in the prostate and bladder neck within days
- 5-alpha reductase inhibitors (finasteride, dutasteride) - shrink the prostate gland over 3–6 months; best for large glands (>40ml)
- Benign prostatic hyperplasia combination therapy - alpha-blocker plus 5ARI for large glands with moderate-severe symptoms
- Anticholinergics or mirabegron added for storage symptoms (frequency, urgency) not resolved by alpha-blockers
- TURP - Transurethral Resection of the Prostate
The established surgical gold standard for BPH:
- TURP surgery for enlarged prostate Mumbai - resection of obstructing prostate tissue using an endoscope passed through the urethra; no external incision
- Bipolar TURP performed in saline - safer than monopolar, reduced risk of TUR syndrome
- Most effective for prostates 30–80ml in size
- Short hospital stay (1–2 nights); catheter removed within 24–48 hours in most cases
- Laser Prostate Surgery - HoLEP / GreenLight
Modern laser alternatives to TURP with excellent outcomes and reduced bleeding:
- Laser prostate surgery Mumbai - Holmium Laser Enucleation of the Prostate (HoLEP) for all prostate sizes, including very large glands (>80ml)
- GreenLight laser vaporisation (PVP) - tissue vaporised with minimal bleeding; ideal for patients on anticoagulants
- Day-care or single-night procedure for most patients
- Durable, long-term symptom relief comparable to open prostatectomy for large glands
- Minimally Invasive Options (UroLift / Rezūm)
Office-based or day-care alternatives for patients preferring to preserve ejaculation:
- UroLift - implants mechanically retract the obstructing lateral lobes of the prostate, opening the channel without tissue removal
- Rezūm - water vapour thermal therapy; steam delivered into prostate tissue causing cell death and shrinkage over weeks
- Both procedures preserve ejaculatory function - important for sexually active younger BPH patients
- Suitable for prostates 30–80ml without a median lobe
- Acute Urinary Retention & Catheter Management
When BPH causes complete inability to void - a urological emergency:
- Emergency urethral catheterisation to drain the bladder and relieve pain
- Trial of void with alpha-blocker therapy initiated - successful in 50–70% at first attempt
- Repeat trial after 48–72 hours if initial trial fails
- Urinary obstruction treatment through elective surgery planned when retention resolves or if trial of void fails
How To Identify Enlarged Prostate (BPH)?
BPH symptoms are divided into two groups - voiding (obstructive) and storage (irritative):
Voiding Symptoms:
- Weak or slow urine stream - reduced flow that has gradually worsened over months to years
- Hesitancy - difficulty starting urination, standing and waiting before flow begins
- Intermittency - the stream stops and starts during voiding
- Straining - needing to push or bear down to empty the bladder
- Incomplete emptying - a persistent feeling that the bladder hasn't fully emptied
Storage Symptoms:
- Frequency - needing to urinate more than 8 times per day
- Nocturia - waking 2 or more times per night to pass urine
- Urgency - sudden, compelling need to urinate that is difficult to defer
- Urge incontinence - leaking urine before reaching the toilet
Gradual worsening of these symptoms over months or years is the hallmark of benign prostatic hyperplasia. Any sudden inability to urinate (acute retention) is a medical emergency.
Treatments For Enlarged Prostate At Shree Hospitals
Medical Therapy (Alpha-Blockers / 5-ARIs / Combination)
First-line pharmacological management - relaxes the prostate and bladder neck (alpha-blockers) and reduces prostate volume over time (5-ARIs). Effective for mild-to-moderate BPH.
TURP (Transurethral Resection of the Prostate)
Endoscopic removal of obstructing prostate tissue through the urethra - the surgical gold standard. Immediate, durable improvement in flow rate. 1–2 night hospital stay.
HoLEP (Holmium Laser Enucleation)
Laser-based enucleation of the entire prostate adenoma - superior to TURP for large glands, with lower re-operation rates. Minimal bleeding, rapid recovery.
GreenLight Laser Vaporisation (PVP)
Safe for patients on blood thinners - laser vaporises obstructing prostatic tissue with minimal bleeding. Day-care procedure with immediate flow improvement.
Top Urologists in Mumbai
Dr. Shyam Mohan
Robotic Urological Surgery, Uro-Oncology
Dr. Alap Mehendale
Urologist, Andrologist, Kidney Transplant Surgeon
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1800-268-4000
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Important FAQs: Enlarged Prostate (BPH)
Is an enlarged prostate the same as prostate cancer?
No - BPH and prostate cancer are completely different conditions. Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland, and it does not increase the risk of developing prostate cancer. However, both conditions can coexist in the same patient, which is why PSA testing and digital rectal examination are part of our prostate evaluation - to ensure no cancer is present alongside the BPH.
At what point should I consider surgery for BPH?
Surgery is recommended when: symptoms are moderate to severe (IPSS >8) and not adequately controlled by medication; you have experienced acute urinary retention; significant post-void residual urine is damaging the bladder or kidneys; or you prefer surgical resolution over lifelong medication. The choice between TURP surgery for enlarged prostate Mumbai, HoLEP, or a minimally invasive option depends on prostate size, anatomy, and your personal priorities - particularly regarding ejaculatory function.
Will BPH surgery affect my sexual function?
Traditional TURP and HoLEP can cause retrograde ejaculation - semen passes backward into the bladder during orgasm rather than out. This is painless and not harmful but affects fertility. Erectile function is generally preserved. Newer procedures - UroLift and Rezūm - are specifically designed to preserve antegrade ejaculation and are preferred by sexually active younger patients when prostate size and anatomy are suitable.
Can I stop my BPH medication after surgery?
In most cases, yes. After surgical treatment - TURP, HoLEP, or laser prostate surgery Mumbai - the obstructing prostate tissue is removed or destroyed, and alpha-blockers and 5ARIs are no longer required. Patients on anticholinergics for storage symptoms may continue these if overactive bladder persists post-surgery. Your urologist will review all medications at the 6-week post-operative appointment.
What happens if BPH is left untreated?
Untreated BPH can progress to chronic urinary retention - the bladder repeatedly fails to empty, causing it to stretch and weaken over time. This leads to bladder damage, recurrent UTIs, bladder stones, and in advanced cases, back-pressure injury to the kidneys (obstructive nephropathy). Urinary obstruction treatment prevents these complications - which is why even moderate symptoms deserve timely urological evaluation.
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