Enlarged Prostate
Singapore

Enlarged Prostate Singapore

Benign Prostatic Hyperplasia (BPH), commonly referred to as an enlarged prostate, is a non-cancerous condition that often develops in men as they age. For those seeking enlarged prostate treatment in Singapore, understanding the condition is important. The prostate gland, located just below the bladder and surrounding the urethra, can increase in size over time. As a result, the enlargement may compress or obstruct the urethra, leading to lower urinary tract symptoms (LUTS) such as frequent urination, urgency, weak urine flow, and nocturia. Ultimately, these symptoms may disrupt daily routines and significantly reduce quality of life.

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Dr. Lie Kwok Ying

Medical Council Certified Urological Specialist

BA MBBChir (Cantab) | MRCS (Edin) | FRCS (Urol)(Glasg) | FAMS

Image

Dr. Lie Kwok Ying

Medical Council Certified Urological Specialist

BA MBBChir (Cantab) | MRCS (Edin) | FRCS (Urol)(Glasg) | FAMS

urologist explaining enlarged prostate treatment in Singapore.

Symptoms of Benign Prostatic Hyperplasia

Men experiencing symptoms of Benign Prostatic Hyperplasia (BPH) may notice urinary changes ranging from mild to severe, which can significantly affect quality of life. For those seeking enlarged prostate treatment in Singapore, understanding these symptoms is the first step toward effective management.

Frequent Urination

An increased urge to pass urine more often than usual, particularly during the night. This often results from incomplete bladder emptying, leading to faster refilling and more frequent voiding.

Urgency

A sudden and compelling need to urinate that is difficult to delay. This symptom often occurs when an enlarged prostate exerts pressure on the bladder, triggering involuntary bladder contractions.

Weak Urine Stream

A noticeable reduction in the force or flow of urine, sometimes requiring straining to initiate or maintain urination. This occurs when an enlarged prostate narrows the urethral passage, limiting urinary flow and pressure.

Intermittent Stream

The urine flow starts and stops repeatedly during urination. This typically occurs when the bladder muscle is unable to sustain enough pressure to overcome the increased urethral resistance caused by an enlarged prostate.

Incomplete Emptying

The persistent feeling that the bladder has not fully emptied after urination. Residual urine left in the bladder increases the risk of urinary tract infections, bladder stones, and other complications.

Difficulty Starting Urination

Experiencing a delay or the need to strain before urine flow begins. This is caused by the enlarged prostate obstructing the bladder outlet.

Dribbling At The End Of Urination

The involuntary leakage or dribbling of urine following completion of urination. This occurs because residual urine remains in the urethra after bladder contraction has ended.

Causes and Risk Factors of Enlarged Prostate

Several factors play a role in the development and progression of Benign Prostatic Hyperplasia (BPH). Common contributors include:

  • Ageing:
    The risk of developing Benign Prostatic Hyperplasia (BPH) rises with age, with prostate enlargement commonly starting in midlife. Age-related changes, including altered cellular regulation and tissue remodeling, may also contribute to prostate growth.
  • Hormonal changes:
    Fluctuations in testosterone and dihydrotestosterone (DHT) levels significantly influence prostate growth. Although testosterone levels decline with age, DHT remains active and continues to stimulate prostate enlargement.
  • Family history:
    A positive family history of Benign Prostatic Hyperplasia (BPH) increases a man’s risk, indicating a potential genetic predisposition to prostate enlargement.
  • Lifestyle factors:
    Unhealthy diet, physical inactivity, and obesity can contribute to the progression of Benign Prostatic Hyperplasia (BPH) by influencing hormone balance and promoting chronic inflammation.
  • Medical conditions:
    Chronic conditions such as heart disease, diabetes, and metabolic syndrome are associated with an increased risk of Benign Prostatic Hyperplasia (BPH) and more severe urinary symptoms. These links are thought to arise from shared inflammatory pathways affecting prostate tissue.

Diagnostic Methods for Enlarged Prostate in Singapore

Accurate diagnosis is essential for effective enlarged prostate treatment in Singapore. A range of diagnostic methods such as physical examination, urine tests and imaging helps doctors determine the severity of BPH and the most suitable treatment options.

Digital Rectal Examination (DRE)

A clinical procedure in which the physician inserts a gloved and lubricated finger into the rectum to evaluate the prostate’s size, shape, and texture. This examination assists in identifying prostate enlargement and detecting any abnormalities.

Urinalysis

A laboratory test analyzing urine to detect signs of infection, blood, or other abnormalities. This test helps rule out urinary tract infections, bladder stones, and other conditions that may mimic symptoms of an enlarged prostate.

Blood Tests

These include prostate-specific antigen (PSA) testing to assess prostate health, along with kidney function tests to determine if chronic urinary problems have impacted renal function. Elevated PSA levels may indicate Benign Prostatic Hyperplasia (BPH), prostatitis, or other prostate-related conditions.

Uroflowmetry

A non-invasive diagnostic test that measures the rate and volume of urine flow during urination. A decreased flow rate may indicate urinary obstruction, often due to an enlarged prostate. This test aids in evaluating the severity of the blockage.

Post-void Residual Volume Measurement

An ultrasound examination used to measure the volume of urine remaining in the bladder after urination. A significant residual volume suggests incomplete bladder emptying, which can increase the risk of urinary tract infections and bladder stones.

Transabdominal Ultrasound

An imaging technique utilizing sound waves to produce detailed measurements of the prostate’s size, shape, and internal structure. This test assists in evaluating prostate enlargement and can guide additional diagnostic procedures if necessary.

Treatment Options for Enlarged Prostate in Singapore

Effective enlarged prostate treatment in Singapore is tailored to the severity of symptoms and the patient’s overall health. Available options include lifestyle changes, medications, minimally invasive procedures and surgery, allowing doctors to select the most suitable approach for each individual.

  • Symptom Monitoring:
    This approach is appropriate for men experiencing mild symptoms that do not substantially impact daily activities. It typically involves regular observation without active treatment. Lifestyle modifications—such as reducing fluid intake in the evening, limiting caffeine and alcohol consumption, and adhering to a scheduled voiding regimen—can help alleviate symptoms. Regular follow-up appointments are important to monitor symptom progression and detect any changes promptly.
  • Alpha Blockers:
    These medications relax the prostate and bladder neck muscles to enhance urine flow. They typically provide symptom relief within days but do not reduce prostate size. Potential side effects include dizziness, headache, and retrograde ejaculation.
  • 5-Alpha Reductase Inhibitors:
    These medications work by blocking dihydrotestosterone (DHT), a hormone responsible for stimulating prostate growth, thereby reducing prostate size. They can decrease prostate volume by approximately 20–30%. Possible side effects include reduced libido, erectile dysfunction, and decreased ejaculate volume.
  • Combination Therapy:
    The simultaneous use of alpha blockers and 5-alpha reductase inhibitors often delivers superior symptom relief compared to either medication alone. This approach is particularly effective for men with larger prostates and moderate to severe symptoms, as it addresses both smooth muscle relaxation and prostate tissue reduction.
  • Phosphodiesterase-5 Inhibitors:
    Medications such as tadalafil can alleviate BPH symptoms by relaxing smooth muscle in the lower urinary tract and enhancing blood flow. This treatment is especially beneficial for men experiencing both BPH and erectile dysfunction. Common side effects may include headache, flushing, and back pain.

  • Transurethral Resection of the Prostate (TURP):
    This surgical procedure removes excess prostate tissue through the urethra using an electric loop. TURP effectively improves urinary flow and offers long-term symptom relief. Recovery usually takes several weeks, and potential side effects include bleeding, urinary tract infections, and retrograde ejaculation.
  • Holmium Laser Enucleation of the Prostate (HoLEP):
    A minimally invasive laser procedure that removes excess prostate tissue, especially effective for larger prostates. The laser precisely cuts and enucleates obstructive tissue, which is then removed through the bladder. HoLEP carries a low risk of bleeding and provides durable symptom relief, making it suitable for patients on blood thinners. HoLEP is the most durable and effective treatment for an enlarged prostate in medical literature.
  • GreenLight Laser Therapy:
    A minimally invasive procedure that uses high-powered laser energy to vaporise excess prostate tissue. This procedure is well-suited for men on blood thinners or those seeking a shorter recovery time. GreenLight Laser Therapy effectively reduces urinary obstruction while minimizing bleeding and hospital stay.
  • Prostatic Urethral Lift (UroLift):
    A minimally invasive procedure that inserts small implants to retract the enlarged prostate tissue away from the urethra, thereby improving urine flow without removing prostate tissue. UroLift preserves sexual function and typically has a shorter recovery time compared to traditional surgical treatments.
  • Water Vapour Therapy (Rezūm):
    A minimally invasive outpatient procedure that uses steam to ablate excess prostate tissue. The heat from the water vapour causes targeted cells to die, and the body gradually absorbs the treated tissue. Rezūm effectively alleviates urinary symptoms while preserving sexual function.

Prevention and Management of Enlarged Prostate

While Benign Prostatic Hyperplasia (BPH) cannot be completely prevented, adopting certain lifestyle changes may help relieve symptoms and slow disease progression. Regular physical activity and a balanced diet rich in fruits, vegetables and whole grains, while reducing red meat intake, can support prostate health. Pelvic floor exercises may improve bladder control, and techniques such as scheduled voiding and double voiding help achieve more complete bladder emptying. Limiting fluid intake in the evening, particularly caffeine and alcohol, can reduce nocturia. Understanding early symptom management is important for those seeking enlarged prostate treatment in Singapore, as it can help prevent complications including urinary retention, bladder stones and kidney problems.

Frequently Asked Questions About Enlarged Prostate

There is no fixed age for prostate screening; however, any urinary symptoms should be promptly evaluated by a healthcare professional. Routine prostate examinations generally begin around age 50 for men at average risk, and may start earlier for those with a family history of prostate conditions or other risk factors.

Benign Prostatic Hyperplasia (BPH) rarely resolves spontaneously. While symptoms may remain stable or vary over time, the condition generally progresses if left unmanaged. Early intervention is important to control symptoms and reduce the risk of complications.

You should seek urgent medical care if you experience an inability to urinate, painful urination accompanied by fever, visible blood in the urine, or severe lower abdominal pain. These symptoms may signal serious complications requiring prompt evaluation and treatment.

Enlarged prostate treatment in Singapore may include lifestyle changes, oral medications, minimally invasive procedures such as HoLEP, UroLift, and Rezūm, as well as surgical options like TURP. It is best to consult a urologist to determine the most suitable treatment based on individual symptoms and health condition.

Minimally invasive treatments for an enlarged prostate, such as HoLEP, are highly effective for many men. They provide relief from urinary symptoms and typically have shorter recovery times compared to traditional surgery.

Yes, certain enlarged prostate treatments in Singapore, such as surgery or procedures done in hospitals, may be covered by Medisave and insurance. It is best to confirm with your urologist and insurance provider.

Recovery time after enlarged prostate surgery depends on the procedure. Minimally invasive options, such as HoLEP, often allow patients to return to normal activities within a few days, while traditional surgeries like TURP may require a few weeks of recovery.

If left untreated, an enlarged prostate can cause worsening urinary symptoms, bladder damage, urinary retention, infections, and even kidney problems. Seeking timely enlarged prostate treatment in Singapore helps prevent complications.

Dr. Lie Kowk Ying- Specialist Urologist

Dr. Lie Kwok Ying

Senior Consultant Urologist

BA MB BChir (Cantab) | MRCS (Edin) | MMEd (Surg) | FRCS (Glasg)(Urol) | FAMS

Dr. Lie Kwok Ying is a Senior Consultant Urologist and a pioneer in the use of Holmium Laser Enucleation of the Prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH) in Singapore.

He graduated from Queens’ College, Cambridge University with triple First Class Honours and completed his medical and surgical degrees in 2001.

Since establishing the HoLEP service, Dr. Lie has performed over 200 procedures, including cases involving patients on anticoagulant therapy and very elderly individuals.

Countless patients have recognised his dedication to patient care, and he is the winner of the “Service with a Heart Award” at Singapore General Hospital (SGH). He has also been awarded the 15-year-long service award in public healthcare. Dr. Lie actively participated in patient care in public hospitals during the SARS and COVID-19 outbreaks and was crucial to the nation’s effort to combat the pandemic crisis. He received the Covid-19 Resilience Medal for his contribution to the nation’s fight against Covid-19.

  • MB BChir University of Cambridge, United Kingdom (2002)
  • MRCS (Surg) Royal College of Surgeons of Edinburgh, UK (2007)
  • FRCS (Urology) Royal College of Physicians, Glasgow, UK (2012)

Dr. Lie helped set up the first HoLEP service in Singapore and is one of the primary urologists to utilise high-power laser platforms in the country for BPH. He has also participated in several seminars and conferences and was a speaker, including the webinar on advances in endoluminal endourology. On top of this, he was also the consultant-in-charge for the website revamp of the Singapore Urological Association.

Research Publications:

  • Choosing the best way for urinary decompression and developing a novel predictive model for septic shock using SOFA in these patients
  • BoNT for idiopathic detrusor overactivity
  • The mystery of gross haematuria in a patient: A case report and literature review

Research in HoLEP:

  • Results from a global multicenter registry of 6,193 patients to refine anatomical enucleation of the prostate (REAP) by evaluating trends and outcomes and nuances of prostate enucleation in a real-world setting
  • Comparison between Thulium Fiber Laser and High-Powered Holmium Laser for Anatomic Endoscopic Enucleation of the Prostate: A Propensity Score-Matched Analysis from the REAP Registry
  • Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non en-bloc techniques: a multicenter, real-world experience of 5,068 patients
  • Influence of early apical release on outcomes in endoscopic enucleation of the prostate: results from a multicenter series of 4,392 patients