By Dr. Jason Phillips, Urologist
Benign Prostatic Hyperplasia, or BPH, is a common condition where the prostate enlarges as men get older. Over 70 percent of men in their 60s experience BPH symptoms and the condition affects more than 500 million men worldwide!
BPH occurs when the prostate, an organ found at the base of the bladder, becomes enlarged and blocks the flow of urine from the bladder through the urethra. While BPH is a benign (non-cancerous) condition, it can cause loss of productivity and sleep, depression and decreased quality of life.
Many times patients remark to me how many of their friends are currently being treated but they never even knew about it! It is very common so talk about it with your wife, your friends or your doctor. Many men who experience mild symptoms may choose to do nothing or “watchfully wait” before taking action.
It is common for men with BPH to experience symptoms such as:
- A frequent need to urinate both day and night
- Weak or slow urinary stream
- A sense that you cannot completely empty your bladder
- Difficulty or delay in starting urination
- Urgent feeling of needing to urinate
- A urinary stream that stops and starts
BPH Treatment Options
Treatment options for BPH range from medications to open surgery, with a variety of minimally invasive options in between.
Medications for BPH include alpha blockers which relax the muscles around the neck of the bladder, making it easier to urinate, and alpha-reductase inhibitors 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. Unfortunately, some patients may suffer side effects including dizziness, headaches, or sexual dysfunction. And while medication is a viable option and some men are satisfied with their results, others may not get adequate relief of their symptoms. Over 17 percent of men on medication for BPH discontinue treatment early for reasons such as being dissatisfied with side-effects or not getting adequate symptom relief.
Thermotherapies are minimally invasive treatments where heat energy such as microwave or radiofrequency is applied to destroy prostate tissue. Less invasive than TURP, these treatments are generally safe, can be performed under local anesthesia and provide moderate symptom relief for some patients. 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 that is attached to a urine bag inserted into their bladder during the recovery period.
Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate (TURP) is the most common surgery to treat BPH. During this procedure, patients undergo general anesthesia and prostate tissue is removed leaving a cavity in place of the obstructive prostate tissue. Patient’s often stay in the hospital overnight and have a catheter post-operatively. Symptom relief may not occur immediately, but patients can expect long term symptom relief after recovery from surgery. Unfortunately, with resection of the prostate with the TURP procedure, there is the possibility of long-term side effects such as dry orgasm (retrograde ejaculation), erectile dysfunction, or incontinence (leaking of urine).
Photoselective Vaporization of the Prostate (PVP)
Laser procedures called photoselective vaporization of the prostate (PVP) are performed with the Greenlight laser. The Greenlight laser PVP lessens the bleeding risks of traditional TURP and is often a better option depending on several factors including prostate size and patient health. I perform this as an outpatient surgery. My patients experience a high success rate in reducing their symptoms and a quicker recovery time as compared to the TURP surgery.
The UroLift® System is a revolutionary minimally invasive procedure to treat an enlarged prostate and has the quickest recovery time. FDA approved in 2013, it is a simple procedure that does not require any cutting, heating, or removal of prostate tissue. I perform the UroLift procedure both in the office setting and at Tri-City Medical Center.
The UroLift device lifts away enlarged prostate tissue so it no longer blocks the urethra with tiny implants to hold the tissue in place, like tiebacks on a window curtain. The procedure is a safe and simple treatment option that offers rapid symptom relief for men suffering from BPH – it is a mechanical solution to a mechanical problem.
Benefits of the UroLift System include the ability to be performed in the office setting without an overnight stay and avoiding the need for catheter while preserving sexual function. No cutting, heating, or removal of tissue is performed. Numerous clinical studies involving hundreds of patients across the world have demonstrated that the UroLift procedure provides a similar level of symptom relief (compared with other BPH procedures), with fewer side effects.
Next Steps for Patients with BPH
Not every treatment is right for every patient. Medications are the starting block for patients with BPH. The goal of any treatment is to relieve symptoms so you can get back to your life and resume your daily activities. Patients who do not want to start or continue their BPH medication, or patients who do not want to undergo major surgery, should consider the minimally invasive UroLift procedure as an alternative. For others with a larger obstructing prostate, other therapies such as the Greenlight laser should be considered.
If you are interested in learning more about BPH, please give me a call and I can walk you through your options when it comes to the TURP, Greenlight laser, and Urolift procedures as treatment options – your success is my success. If you or someone you know is suffering from their urinary symptoms please call our referral line at 855-222-8262 and ask for my office!