Can I avoid invasive surgery to sort my enlarged prostate?

I AM awaiting an operation to treat an enlarged prostate, after various tablets failed to work. My consultant has told me there are a few types of procedures they cannot offer me – such as less invasive ones. Should I seek a second opinion?

PROSTATE problems are very common in older men. And one that we see very often is an enlarged prostate, which happens when the gland gets too large and pushes on the bladder.

This causes a range of distressing symptoms, such as going to the toilet often at night and feeling you haven’t emptied your bladder properly.

Often, men find their symptoms resolve easily with medication. But if not, surgery is offered.

When it comes to operations, the NHS has a few options. The one patients get will depend on factors like other health concerns and the specifics of their prostate problems.

One commonly performed operation is transurethral incision of the prostate, or TUIP.

Here, there is no open surgery involved as doctors access the affected area via the penis. It means a shorter hospital stay for patients and fewer side effects.

Another type of procedure is called a TURP, in which part of the prostate is removed. Also performed through the penis, it is more invasive than TUIP, so patients need to stay in hospital for longer. It can also cause problems with sexual function.

There are lots of newer techniques for prostate enlargement too. But not every urology centre offers them.

Prostate surgery is very much a current area of innovation in the NHS. One example is a procedure whereby the prostate is cut away using a laser, while another type of operation uses a vapourising method. There is also a ‘lift’, where an implant is inserted to separate the prostate from the bladder. Patients don’t normally need to stay in hospital for this.

These methods have been developed to reduce side effects and improve men’s quality of life.

MY FINGERTIPS have started to feel sore and the skin suddenly looks thicker – and not just after being in water or in the cold. Should I be concerned? I am 60.

ALL skin conditions are horrid, but the ones that affect the hands can be especially inconvenient.

The problem is hard to treat because smearing hands in cream makes daily tasks impossible.

Eczema may well affect the fingertips, causing dryness, peeling skin and pain. It can be treated by avoiding soap and using thick emollient creams that are available on prescription or from the pharmacist. We often advise patients to use a cream soap to wash with and use a treatment cream like hydrocortisone before bed, so it doesn’t get wiped off.

Sore fingertips can also be a sign of a common bloodcirculation problem called Raynaud’s. The fingertips can look wrinkly and change colour – going white or even purple – and feel sore or numb.

The symptoms are triggered by changes in temperature, such as very cold weather, as well as stress and caffeine.

There are more unusual diseases that may affect the way the fingertips look. These include connective tissue or rheumatological conditions like lupus or systemic sclerosis.

These diseases affect multiple parts of the body, including the connective tissues within the skin – causing tightness and pain.

The skin can harden and become thick, which might make joints in the finger feel stiff and painful.

CAN you help my 75-year-old mother? My father recently died and she has lost a huge amount of weight – she is skin and bones and suddenly very frail. I have tried to fill her fridge with sweet treats, but she isn’t eating them and is getting thinner and thinner. Is there a quick way to help her gain weight?

IT IS not uncommon for people to lose a lot of weight after a bereavement. Grief and sadness are factors, but there are also the practical things such as no longer shopping and cooking for another person.

It’s worth noting that dramatic weight loss can also be a symptom of serious illness that could be going on at the same time. Cancer is one – and should always be considered in a elderly person losing weight. A GP would run urgent tests and perhaps even hospital investigations to ensure nothing is missed.

High-calorie foods are best for someone with a small appetite so the person doesn’t have to eat vast quantities. So, for instance, go for nuts, dried fruit, peanut butter, oily fish, avocado and milky drinks.

Adding cream, ground nuts and oils to foods can help too.

There are also special medical milky drinks you can try that pack 300 calories into a 200ml bottle. Some patients find it useful to add them to their normal diet.

Large meals can be uncomfortable, causing people to get full very quickly. Smaller meals and regular snacks may be easier.

Having meals prepared in the fridge and an easy-to-use microwave can also help.

Being frail and eating little puts elderly people at risk of significant health issues such as osteoporosis and infections.

A GP as may advise taking Vitamin D and calcium to help prevent some of these problems.