An enlarged prostate or Benign Prostatic Hyperplasia (BPH) can lead to various urinary symptoms that significantly impact a man’s quality of life. Proper diagnosis and treatment are essential for managing this condition. In this article, we explore the options for screening, diagnosis, and also for enlarged prostate treatment in Singapore.
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Prostate Health Screening
There are 2 tests for prostate health that are often included in general health screening packages – a prostate ultrasound, and a Prostate-Specific Antigen (PSA) blood test. A prostate ultrasound is used to check the size and shape of the prostate gland and nearby structures. It can help to discover conditions such as enlarged prostate or prostate cancer. The Prostate-Specific Antigen test measures the level of PSA in the blood. It is a tumour marker test that can aid in the early detection of prostate cancer. Elevated PSA levels may also be caused by inflammation of the prostate.
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Prostate ultrasound and PSA tests are recommended for men over the age of 50, especially those with a family history of prostate conditions.
Diagnosing Enlarged Prostate
If an enlarged prostate condition is suspected, the doctor may carry out additional tests to confirm the diagnosis. These tests can include:
- Digital Rectal Exam (DRE): The doctor inserts a finger into the rectum to check the size of the prostate.
- Prostate-Specific Antigen (PSA) Test: Measures the level of PSA in the blood, which can be elevated in BPH.
- Urinalysis: Checks for infection or other conditions that could be causing symptoms.
- Ultrasound: Provides an image of the prostate and bladder.
- Urodynamic Tests: Measure bladder pressure and urine flow.
- Cystoscopy: A scope is inserted into the urethra to examine the bladder and prostate.
Options For Enlarged Prostate Treatment, Singapore
Treatment and management of enlarged prostate depends on the severity of symptoms and the size of the prostate. Options include:
- Lifestyle Changes
- Reduce fluid intake, especially before bedtime.
- Limit caffeine and alcohol.
- Regular exercise.
- Medications
- Alpha-Blockers: Relax the muscles of the prostate and bladder neck, making it easier to urinate. However, while they provide symptomatic relief, they do not reduce the size of the prostate.
- 5-Alpha Reductase Inhibitors: Shrink the prostate by reducing the level of the dihydrotestosterone (DHT) hormone in the body. DHT plays a significant role in prostate development, and controlling DHT levels can reduce the size of an enlarged prostate.
- Minimally Invasive Procedures
- Convective Water Vapour Thermal Therapy: This treatment is aimed at improving urine flow. Using steam injections, targeted prostate cells are killed. This reduces the size of the prostate and alleviates the symptoms of BPH.
- Prostatic Urethral Lift: Small implants are placed in the body to hold the enlarged prostate tissue away from the urethra. This opens up the urethra and urine flow is improved.
- Surgical Options
- Transurethral Resection of the Prostate (TURP): This is the most common and effective surgical treatment for enlarged prostate, in particular, when they are large and highly obstructing prostates. This treatment involves the surgical removal of part of the prostate, thereby relieving the blockage of the urethra.
- Laser Therapy: This treatment uses laser to remove excess prostate tissue.
- Simple Prostatectomy: This is a surgical procedure used to treat prostates that are severely enlarged, and when other treatments are unsuitable or have already been tried without success. This treatment involves surgically removing the inside part of the prostate gland.
Estimated Cost Of Enlarged Prostate Treatment, Singapore
Based on MOH benchmarks (assessed 21 Nov 24), the average historical costs of enlarged prostate treatment in Singapore by minimally invasive surgery (TOSP Code: SH832P) are:
| Setting | Ward Type | Typical Bill | Typical Bill Range | Typical Bill Items | ||
|---|---|---|---|---|---|---|
| Operation Fee | Implant Fee1 | Other Fee2 | ||||
| Public Hospitals | Day Surgery (Subsidised) | $5,496 | $3,232 – $6,312 | $1,855 | Not Available | $2,425 |
| Day Surgery (Unsubsidised) | $8,847 | $7,952 – $9,953 | $3,282 | Not Available | $5,551 | |
| Private Hospitals | Day Surgery | $13,495 | $12,056 – $15,919 | $11,777 | Not Available | $1,398 |
| 1 Fee for the medical device(s)/ implants placed inside the body. Applicable only if your procedure requires an implant. 2 Includes ward charges, doctor’s daily attendance and consultation fee, consumables, medication, tests, accident & emergency charges etc., where applicable. Note: Figures shown are based on the median fee, i.e., what 50% of patients are charged below. They provide an estimate and may not add up. | ||||||
The MOH recommended benchmark fees are:
| Type of Fees | Fee Range | |
|---|---|---|
| Doctor Fees | ||
| Surgeon Fee1 | $3,706 – $4,905 w/GST ($3,400 – $4,500 w/o GST) | |
| Anaesthetist Fee | Not Available | |
| Inpatient Doctors’ Attendance Fees2 | $230 – $450 w/GST per day ($210 – $420 w/o GST per day) | |
| Hospital Fees | Hospital Fees | Not Available |
| 1 Higher end of surgeon fees may be associated with more complex cases. 2 Fee range is for office hours only and does not include the costs of medications, injections, operations, special procedures, investigations (e.g., radiological and laboratory tests). | ||
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.