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Benign Prostatic Hyperplasia (Enlarged Prostate)

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Prostate enlargement, or benign prostatic hyperplasia (BPH), is a common condition among aging men. Most often characterized by bladder control problems, not all men experience symptoms, but those who do should consult their provider if those symptoms begin to interfere with daily activities.


Symptoms

The most common symptom of BPH is trouble urinating. This may include:

  • A weak urine stream
  • Difficulty starting urination
  • Increased urinating at night
  • Straining to urinate
  • Not being able to completely empty the bladder.

Urinary tract infections and developing bladder stones are also symptoms of BPH. Patients experiencing these symptoms should schedule an appointment with their provider as soon as possible, as they may also be caused by a more serious condition such as prostate cancer.


Diagnosis

In order to diagnose BPH, providers will first collect detailed information about the symptoms being experienced.

A digital rectal exam will allow observation on the physical state of the prostate gland; a neurological exam will reveal any loss of nerve function crucial to proper urinary function; and a urinalysis allows doctors to rule out infections or any other condition.


Treatment

Treatments for BPH ranges from medication to surgery, depending on the severity of the symptoms experienced and the health risks involved for the patient.

Common treatments include drugs such as alpha blockers, 5 alpha reductase inhibitors, a combination of the two, or PDE 5 inhibitors.

If symptoms are too much of a health risk to moderate with drug treatments, doctors may recommend any one of many surgical options to correct BPH. TURP (transurethral resection of the prostate) is a common choice, though TUIP (transurethral incision of the prostate) is more appropriate for patients at risk for complications with other surgeries. Transurethral vaporization of the prostate (TUVP) is another minimally invasive procedure to relieve symptoms of an enlarged prostate.

Transurethral resection of the prostate, or TURP, is a surgery to help patients with BPH causing symptoms or blockage. It is one of the most common procedures performed by Urologists.

TURP involves the use of specialized cameras and tools to open the channel in the prostate where the urine flows - this typically involves an overnight stay in the hospital.

Transurethral vaporization of the prostate (TUVP) is a minimally invasive procedure for relieving symptoms of an enlarged prostate. Some patients suffering from an enlarged prostate (BPH) are candidates for a TUVP.

Click the image below to view and download an informational PDF about this procedure.

For patients who have an enlarged prostate causing symptoms such as obstruction (blockage), prostate surgery may be an option. Ask your provider for further details on these procedures.

Plasma Button Vaporization offers the advantage of less catheter time, and less bleeding when compared to classic TURP.

Green Light Laser Photo Vaporization offers the advantage of an outpatient surgery, less catheter time, and less bleeding when compared to TURP. This procedure may also be used on patients who are unable to stop their blood thinners.

More information can be found here.

If the prostate has become severely enlarged, open prostatectomy may be the most appropriate option. However, it is typically not a first choice due to the risk of side effects.

Increasingly, doctors suggest minimally invasive solutions for BPH. There are a wide variety of minimally invasive procedures to correct an enlarged prostate, with some of the most common being:

  • Laser therapy, called HOLAP (Holmium Laser Ablation of the Prostate)
  • Transurethral microwave therapy (TUMT)
  • Transurethral needle ablation (TUNA)
  • Prostatic stents