Middle-aged men usually don't have the name for it, but they know the drill. It's frequent urination (at least once or twice a night, interrupting sleep), a sensation of incomplete emptying of the bladder, a stream that starts and stops, difficulty starting urination, residual dribbling of urine and returning to urinate almost immediately after finishing.
Sound familiar? These symptoms describe the effects of an enlarged prostate, often called benign prostate hyperplasia, or BPH. It is, by far, the most common prostate issue for men over 50. It affects about half of men between age 51 and 60 and up to 90 percent of men older than 80.
Fortunately, it's not cancerous.
But it can be both a disruption and aggravation in your daily life. Once you’ve been diagnosed with an enlarged prostate, your Tallwood urologist will determine the best way to restore normal urination frequency and normal urine flow.
How Is BPH/Enlarged Prostate Diagnosed?
A physical exam, blood and urine tests, your medical history and symptoms are all considered when diagnosing an enlarged prostate.
How to evaluate your urinary symptoms? The American Urological Association's BPH Symptom Score uses these seven questions:
- How often have you had a sensation of not emptying your bladder completely after you finished urinating?
- How often have you had to urinate again less than 2 hours after you finished urinating?
- How often have you stopped and started again several times when you urinated?
- How often have you found it difficult to urinate?
- How often have you had a weak urinary stream?
- How often have you had to push or strain to begin urination?
- How many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?
The Conservative Approach
Depending on the severity of your symptoms, your doctor might choose a conservative treatment that includes lifestyle changes such as:
- Reducing stress, which can trigger more frequent urination.
- Regular exercise.
- Maintaining a healthy weight.
- Avoiding alcohol and caffeine, particularly after dinner.
- Avoiding decongestants or antihistamines, which make it more difficult for the bladder to empty.
- Urinating as soon as you feel the urge.
Medications such as alpha blockers that relax bladder and prostate muscles can help, though some patients report dizziness, fatigue, lightheadedness and other side effects.
Surgery For Benign Prostate Hyperplasia
If your modern to severe BPH symptoms do not respond to medication, you doctor might recommend one of these procedures:
Transurethral resection of the prostate (TURP): During a TURP procedure, a standard surgical treatment for BPH, your doctor shaves away blocking tissue in the prostate with an instrument inserted through your urethra.
Transurethral incision of the prostate (TUIP): Unlike a TURP, your prostate tissue is not shaved away during a TUIP. To restore free urine flow in milder cases of BPH, incisions in the prostate allow the gland to expand and increase the size of the bladder outlet and urethra.
“Simple” prostatectomy: The inner part of the prostate, including the part of the gland blocking urine, is removed.
Hartford HealthCare also offers this outpatient procedure:
Holmium laser enucleation of the prostate (HOLEP): In a HOLEP procedure, your doctor uses a laser to open an obstructing prostate by peeling away the obstructing tissue. The laser reduces bleeding during the operation and thus can be used even in very large prostates.
Other Options
The Tallwood experts also offer other techniques for treating BPH.
Rezūm™
The Rezūm system uses thermal energy in the form of sterile water vapor (steam) to remove the extra tissue cells generated in the prostate by BPH. The steam is created using radiofrequency power and administered in controlled doses through a needle ablation through the urethra. Condensation releases the stored thermal energy of water vapor against the walls of the cells in the treatment zone. Removal of the tissue – which is eventually absorbed by the body – reduces the urethra obstruction, relieving lower urinary tract symptoms of BPH and improving urine flow.
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UroLift®
A new, minimally invasive treatment called UroLift now allows doctors to treat an enlarged prostate by peeling back excess tissue using tiny implants to reduce pressure on the urethra. It’s the first BPH treatment that does not remove prostate tissue. It also does not affect sexual function. UroLift is often performed under local anesthetic, with no catheter or overnight stay in the hospital.
The UroLift System is an alternative for patients looking for something other than drug therapy or more invasive surgery. Treatment might be right for you if any of the following apply:
- You do not want to take another pill every day.
- You have tried BPH medication but are unhappy with the side effects.
- You do not want to undergo major surgery due to potential surgical risks of side effects and complications.
- You want a BPH treatment that preserves your sexual function.
- You want to regain your quality of life with minimal downtime.
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