Jakarta, IO – Prostate enlargement is common in men’s fifth decade of life, with an estimated incidence of nearly 50%. The prostate, an organ unique to men, is located deep in the pelvic cavity, between the penis and the bladder. This organ functions as a gland that produces prostate fluid and together with fluid from the surrounding glands (seminal vesicles) it will make up more than 90% of the seminal fluid.
“This fluid contains nutrients that sperm will use to survive and fertilize the egg/ovum. Seminal fluid and sperm fluid are different. Sperm fluid only makes up less than 5% of the seminal fluid, the rest is fluid from the prostate and surrounding glands,” said dr. Adistra Imam Satjakoesoemah, Sp.U, FICS, a urologist from Abdi Waluyo Hospital, Jakarta, in a media briefing held Thursday (28/3/2024).
The urinary tract/urethra is nestled in the middle of the prostate. An internal urinary valve (internal sphincter) attached to the prostate functions to regulate the outflow of ejaculatory fluid and urine. Enlargement of the prostate can cause obstruction and problems with urination. These symptoms are commonly called “Lower Urinary Tract Symptoms” (LUTS).
“The prostate is a male sexual organ. Therefore, any treatment for prostate disorders can cause sexual dysfunction in men. Treatment of urinary disorders due to an enlarged prostate aims to control/reduce prostate growth and improve urinary flow. The prostate grows from stimulation by the substance dihydrotestosterone (DHT), which is a derivative product of testosterone, a hormone whose main function is to maintain sexual function, such as sexual arousal (libido), erections, and secondary sexual growth (mustache or pubic hair),” he explained.
Therefore, treatment to control prostate growth will be related to the regulation of the hormone testosterone. Treatment can decrease libido, result in erectile dysfunction, mood disorders, etc. Meanwhile, therapy to facilitate urination can disrupt the performance of the urinary valve that regulates ejaculation, thereby risking causing retrograde ejaculation or “empty ejaculation”. This condition occurs when a man engages in sexual activity and has reached orgasm, but no seminal fluid can be released.
“Water vapor thermal therapy will minimize this disturbance. This therapy uses radio frequencies to create energy in the form of water vapor. With the help of special instruments and a small camera inserted into the urethra, hot steam with a temperature of 103 degrees will be injected directly into the patient’s prostate with precision. The number of injections or treatments given depends on the size of the patient’s prostate and the surgeon’s clinical judgment,” he said.
Minimal Recurrence Rate
Then he added that important structures such as the internal urinary valve, as a regulator of ejaculation and the ejaculatory duct must be preserved as optimally as possible, to reduce the risk of ejaculation disorders. Hot steam will cause widespread and even prostate cell death because it spreads by convection. The dead cells will slowly be absorbed by the body; within 2 to 4 weeks the patient’s complaints will improve, and the most optimal results will be obtained around 1-3 months after the procedure. “This procedure does not use general or spinal anesthesia, just light sedation.
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The procedure is also very fast, from anesthesia to the procedure: it only takes around 10-20 minutes with minimal bleeding. Patients can go home immediately after the procedure if their condition is stable. However, water vapor thermal therapy is only recommended for prostates that are not too large, the most ideal volume being between 30-80 ml, with a reference to the normal prostate volume being below 25-30 ml,” he warned.
Can it be done for prostates larger than 80 ml?
“It is possible, but the risks and benefits must be carefully considered. Patients may be advised to undergo more effective therapies, such as prostate laser surgery. The choice of therapy must go through an assessment from a doctor, with the ultimate goal being that the patient can be free from drugs, the quality of life will improve, and the recurrence rate is relatively minimal,” he answered. (est)
