Enlarged Prostate

Introduction

With age, the prostate often increases in size in most men. About half of men with enlarged prostate may have symptoms related to it. As the prostate gland grows larger, it can put pressure on the internal urethra (the channel that passes urine from the bladder to the penis. This may interfere with the flow of urine, and prevent the bladder from emptying fully.

Symptoms may include trouble starting urination, weak urine stream, dribbling, feeling like you can't empty your bladder, leaking urine, frequent urge to urinate. It is common to wake up several times during the night to urinate. There may be an increased risk of urinary infections and bladder stones. It is even possible for the enlarged prostate gland to block off urine flow completely. If this occurs, a catheter will be needed to drain the bladder.

An enlarged prostate does not increase your risk for cancer; however, it is recommended for most men over 50 to have a screening prostate exam yearly to detect early prostate cancer which is the most common form of cancer in men. Prostate cancer causes no symptoms in the early stages when treatment is most effective. If your father or brother had prostate cancer or you are African American, you may be at a higher risk and screening is recommended to start at the age 40. Also, it appears that a high fat diet increases your risk of prostate cancer.

Your condition may improve, remain the same or become worse. If symptoms are mild you may choose no treatment at this time. For moderate or severe symptoms, treatment will be offered. All treatment options are aimed to improve urine flow improve emptying, and reduce symptoms. Treatments include drug therapy, minimally invasive procedures and surgery. Each varies in their risks and expected benefits. You can discuss options with your doctor.

Treatment

Oral Medication

  1. Alpha-blockers
    • This medication relaxes the muscles in the prostate and bladder neck, making it easier to urinate.
    • Common Side Effects include nasal congestion, orthostatic hypotension, dizziness, retrograde ejaculation.
    • This medication is best taken at night.
    • IV. Ex: Tamsulosin(Flomax ©), doxasozin, alfusosin(uroxatral©), Rapaflo©, Terazosin
  2. Alpha reductase inhibitors
    • Prevents the conversion of testosterone to its active ingredient dihydrotestosterone (DHT). DHT is involved in the development of benign prostatic hyperplasia.
    • Common side effects include decreased libido, erectile dysfunction, nipple tenderness or enlargement
    • Ex: Finasteride, Dutasteride

Surgical

  1. Urolift
    • The UroLift® System is minimally invasive approach to treating an enlarged prostate, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. This can be done very quickly in the office with minimal risk of affecting ejaculation. For more information visit http://urolift.com/urolift-system/
  2. Laser Vaporization of the Prostate
    • This procedure uses high powered laser light to vaporize prostatic overgrowth.
    • For more information:
  3. Trans Urethral Resection of the Prostate
    • This is a surgical procedure in which a surgical instrument is inserted through the urethra to remove parts of the prostate gland. No incisions are needed and is done in a hospital setting, often as an outpatient using the latest “bipolar” Technology.
  4. Rezum
    • Rezūm is a transurethral needle ablation* procedure to treat benign prostatic hyperplasia (BPH) that can be performed in a clinic or out-patient setting. It delivers radiofrequency generated thermal therapy, in the form of water vapor or steam, directly to the extra prostate tissue. This energy transferred by the water damages the cells, causing cell death. Over time, your body will absorb the treated tissue through its natural healing response. For more information visit www.rezum.com.
      ** taken from http://www.rezum.com/the-rezum-system/