If you suffer from an enlarged prostate, you are not alone. BPH is one of the leading reasons for men to visit a urologist.
What is an enlarged prostate?
The prostate is a male reproductive gland, about the size of a walnut, that produces fluid for semen. Benign prostatic hyperplasia (or BPH) is what is known as prostate gland enlargement and occurs when prostate cells continue to multiply increasing the size of the prostate and eventually causing blockages to the urethra. BPH is very common, with 3 million new cases in the US on an annual basis. Furthermore, more than half of men suffer from BPH by the age of 60, and over 90% of men by the age of 90.
What causes this to occur?
Although it is not 100% known what causes enlargement, the general consensus in the medical community is that prostate enlargement is linked to the hormonal changes that arise as men grow older. As the balance of hormones in your body shifts, this may cause your prostate to grow and cause issues down the road, or more immediately.
What are the symptoms of an enlarged prostate?
Symptoms include:
- Frequent urination
- A weak or slow urinary stream
- A feeling of incomplete bladder emptying
- Difficulty starting urination
- Urgency to urinate
- Getting up frequently at night to urinate
- A urinary stream that starts and stops
- Straining to urinate
- Continued dribbling of urine
- Returning to urinate again minutes after finishing
If you suffer from the symptoms above, you are not alone. BPH is one of the leading reasons for men to visit a urologist.
What can be done to fix an enlarged prostate?
BPH can be treated in a variety of ways, starting with medicine and ranging up to surgical interventions. Dr. Coleman would navigate all of these options with you to see what works best for you. See our BPH treatment options below.
Treatments available
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Observation is a reasonable option for some men.
When symptoms are mild, your doctor may just monitor your condition and ask you to track your symptoms before deciding if any treatment is necessary.
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Medications can be helpful in relieving symptoms for some men.
Your doctor may prescribe medications to manage your symptoms. These medications include alpha blockers like Flomax or Tamsulosin which relax the muscles around the neck of your bladder, making it easier to urinate, and alpha reductase inhibitors like Proscar or Finasteride which act to shrink the prostate. While medications can be helpful in relieving symptoms for some men, patients must continue taking them long-term to maintain the effects.
Some patients may suffer side-effects including dizziness, headaches, or sexual dysfunction. Some may not get adequate relief of their symptoms. Over 16% of men on medication for BPH discontinue treatment early for reasons such as being dissatisfied with side-effects or not getting adequate symptom relief.
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FDA cleared BPH treatment for enlarged prostate.
The UroLift® System treatment is a minimally invasive approach to treating BPH that pins back or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating,removal of prostate tissue. With no destruction of prostate tissue there is no prolonged healing of this tissue. Clinical data has shown that the UroLift® System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without any impact to sexual function.
Learn more about how the UroLift® System treatment works or visit our FAQ page for more information on the benefits, risks, and recovery.
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Transurethral Microwave Therapy (TUMT)
Thermotherapies are considered less invasive treatments, but the result of all of these therapies is destruction of tissue that involves applying heat to the obstructing prostate in the form of microwave, steam, or radio frequency. After these treatments, the tissue has to heal from the therapy which can be a prolonged process.
Applying high heat to the prostate can cause tissue swelling and uncomfortable urinary symptoms during the healing period. Symptom relief does not occur immediately, and patients often need to have a catheter for several days that is attached to a urine bag inserted into their bladder during the recovery period.
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Laser Resection of the Prostate (LASER)
Green light laser is performed under general anesthesia in procedures called photoselective vaporization of the prostate (PVP) and another procedure holmium laser enucleation (HOLEP). Laser therapy lessens the bleeding risks of traditional TURP. However, since prostate tissue is still destroyed, there can be tissue swelling and an uncomfortable prolonged healing time. Typically, a catheter has to be inserted into the bladder after the procedure for several days.
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Transurethral Resection of the Prostate (TURP)
TURP is the most common surgery to treat BPH. During this procedure, patients undergo general anesthesia, and prostate tissue is removed. One advantage of the TURP is that the tissue removed can be examined by the pathologist to make sure there is no cancer in the prostate (with the laser and thermotherapy treatments this is not an option).
At the end of the procedure a catheter is placed through the penis into the bladder with continuous bladder irrigation to flush out the blood in the urine. The patient is admitted to the hospital overnight and most of the time there is very little bleeding the next morning. Most patients stay overnight one or two nights and the catheter is almost always removed before discharge.
Symptom relief may not occur immediately, but lasts for a long time in many patients once it does occur.
Most patients have a lot of frequency and urgency with occasional blood in the urine that may last 1 to 2 weeks. There are some potential sexual side effects associated with a TURP that are not seen with the Urolift. Dr. Coleman can explain these issues in detail in the office.
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