Iam a 54 years diabetic male.My HbA1c is 6.0 recently I have been diagnosed with enlarged prostate 34gms.I feel discomfort and urge to urinate even with small amounts of urine.This problem gets aggravated at night,and becomes more severe when travelling in bus or train.Do I have an overactive bladder too?

Hello Ashwani Kumar Dubey Ji,

Thank you for sharing your detailed concern. At 54 years of age, being a well-controlled diabetic (HbA1c 6.0%) is a positive sign. However, your recent diagnosis of an enlarged prostate (34 grams), along with frequent urination, urgency, nighttime discomfort, and increased symptoms during travel, suggests a combination of Benign Prostatic Hyperplasia (BPH) and possibly Overactive Bladder (OAB).

What May Be Causing Your Symptoms of BPH and Overactive Bladder?

1. Benign Prostatic Hyperplasia (BPH):
   As the prostate enlarges, it can partially block urine flow, leading to:

   • Frequent urination

   • Sudden urge to urinate

   • Weak stream or dribbling

   • Nighttime urination (nocturia)

2. Overactive Bladder (OAB):
   This includes sudden, intense urges to urinate—even when the bladder isn’t full.
   Diabetes can worsen this by irritating the bladder nerves.

Is Surgery Required?

Not always. At 34 grams, your prostate size is considered mild to moderate. Most patients with this condition start with medications and lifestyle changes, which often bring good relief.

However, surgery may be required if:

• Medications don’t work after 3–6 months

• You face urine retention or a very weak stream

• You experience recurrent UTIs, bladder stones, or kidney involvement

• Nighttime symptoms and travel urgency severely affect your routine

Surgical Options (If Needed):

1. TURP (Transurethral Resection of the Prostate):

   • Most common method

   • Removes excess prostate tissue without external cuts

   • Offers fast and effective symptom relief

2. Laser Surgery (HoLEP, GreenLight):

   • Minimally invasive with less bleeding

   • Ideal for diabetic patients or those with bleeding concerns

3. Prostate Artery Embolisation (PAE):

   • A non-surgical, radiology-guided day-care procedure

   • Shrinks the prostate gradually by cutting off the blood supply

Benefits of Surgery (if advised):

• Long-term relief from frequent urination and urgency

• Better sleep and comfort during travel

• Improved urine flow and reduced bladder strain

• Lower risk of kidney damage and future complications

What You Should Do Next:

• Consult a urologist for further evaluation

• You may need tests like a bladder scan, uroflowmetry, and urine tests

• Discuss both medical and surgical options based on your symptoms and preferences

Wishing you good health!

Let me know if you’d like help booking a trusted urologist in Bhopal or arranging a second opinion on whether surgery is right for you.