Prostate Treatment — Accurate Diagnosis, Right Treatment, Not Just Surgery

BPH (Benign Prostatic Hyperplasia) is a non-cancerous enlargement of the prostate — extremely common in men over 50. Not every patient needs surgery. Mild-to-moderate symptoms are often well-controlled with daily medications (alpha-blockers and 5-ARIs). Surgery is recommended only when symptoms are severe, medicines fail, or complications such as urinary retention, bladder damage or kidney problems develop.

HoLEP (Holmium Laser Enucleation of the Prostate) is the gold standard for BPH surgery. It removes the entire obstructing prostate tissue through the urethra — with no skin incision. Compared to TURP, HoLEP has significantly lower re-treatment rates (less than 1% at 10 years), less bleeding, and works on any prostate size. Most patients go home within 24 hours.

HoLEP is performed under spinal or general anaesthesia — you feel nothing during the procedure. Mild urinary symptoms (frequency, urgency) are common for the first 2–4 weeks as the urethra heals. Most patients are discharged within 24 hours, return to desk work in 1–2 weeks and resume full activity in 4–6 weeks. The long-term improvement in urinary flow is typically dramatic.

A PSA above 4 ng/mL warrants evaluation, but an elevated PSA does not necessarily mean cancer — BPH, prostatitis, recent ejaculation or even vigorous cycling can raise PSA. Age-specific PSA ranges exist, and PSA density and velocity (rate of rise) are also considered. Our urologist will review your full clinical picture — not just the number — before recommending further tests.

Permanent urinary incontinence after HoLEP is very rare — occurring in less than 1% of patients. Most men experience temporary stress incontinence (leaking on coughing or exercise) for 2–6 weeks after catheter removal. Structured pelvic floor exercises, which we teach before surgery, resolve this in the vast majority of patients. Our urologist will discuss all risks honestly during your pre-operative consultation.

Yes — prostatitis (especially acute bacterial) can substantially raise PSA, sometimes to double-digit levels, without any cancer. This is why elevated PSA should never trigger an immediate biopsy without excluding infection first. Diagnosis involves urine culture, IPSS symptom score, uroflowmetry and sometimes a prostate ultrasound. Treating prostatitis will lower PSA if it was the cause.

Yes — HoLEP, TURP and prostatitis treatment are covered by most health insurance policies in India. Trayam Hospital is empanelled with all major insurers including cashless facility. Our dedicated insurance desk manages pre-authorisation and claim support from the day of your consultation.

Men over 50 should have an annual prostate health check including PSA blood test and clinical examination. Men with a father or brother who had prostate cancer should start screening at 40–45 years. Any man of any age with urinary symptoms — difficulty starting, weak stream, night-time urination — should consult a urologist rather than waiting for an annual check.

BPH is a non-cancerous enlargement of the prostate that causes urinary symptoms — it does not spread and is not life-threatening. Prostate cancer is a malignancy that may cause similar or no symptoms in early stages. Having BPH does not increase your risk of prostate cancer. Both conditions are diagnosed and managed differently. PSA testing, digital rectal examination and biopsy (when indicated) are used to differentiate them accurately.