OVERVIEW
BPH is a common condition as men age. It involves benign (non-cancerous) enlargement of the prostate. When the prostate grows, it can block the flow of urine leading to lower urinary tract symptoms, also known as LUTS.
Symptoms
You may experience one, some, or all of the following symptoms:
- urinary frequency
- the sudden urge to urinate
- weaker stream
- incomplete emptying of the bladder
- straining to urinate
- difficulty starting your urinary stream
- waking up at night to urinate.
Causes
Urinary symptoms, although commonly related to an enlarged prostate in men, can also be due to urinary tract infections, bladder or kidney stones, urethral stricture/scar tissue formation, inflammation of the prostate (prostatitis), problem with the nerves to the bladder, or a cancer of the bladder or prostate.
Diagnosis/Evaluation
- What to know before your visit
- During your visit, your doctor will ask you questions regarding your medical history and will perform an exam with focused attention to the abdomen and genitalia. The physician may have you fill out a short survey with questions regarding how you urinate.
- Tests that may be performed during or after your visit:
- Digital rectal exam: The physician inserts a finger into your rectum to check for the size of your prostate and to evaluate for any abnormalities
- Urinalysis: A urine test to evaluate for any blood in the urine or infection
- Post-void residual: The physician will often ask you to urinate and then check to make sure you are emptying your bladde
- Urine flow: The physician may have you urinate in a funnel to assess the speed of your urinary stream
- Cystoscopy: This is a procedure performed in the office where the physician inserts a small scope into the penis to assess the urethra for any scar tissue and evaluate the prostate for any evidence of obstruction
- Urodynamics: This is a test where a small tube is inserted into the penis and another into the rectum to help measure the pressures in the bladder during urination
Treatment
NON-SURGICAL TREATMENT
- Alpha blockers: Relaxes the prostatic urethra and bladder neck, making urination less difficult,
- Most common medications include tamsulosin (Flomax), silodosin (Rapaflo), and alfuzosin (Uroxatral)
- 5-alpha reductase inhibitors: Shrinks the prostate (takes 4-6 months to start working)
- Most common medications include finasteride (Proscar) and Dutasteride (Avodart)
- Tadalafil (Cialis): Improves quality of life related to urination and also is used to treat erectile dysfunction
SURGICAL TREATMENT
- Prostatic Urethral Lift (UroLift®): A minimally invasive procedure involving implantation of suture material to move the prostate away from the urethra and correct the obstruction. Click here to learn more about UroLift®.
- Laser Prostatectomy: This involves a scope in the urethra (tip of penis) with laser vaporization of prostatic tissue
- Transurethral resection of prostate (TURP): This involves a scope in the urethra (tip of penis) with resection and removal of prostatic tissue
- HOLEP: This involves a scope in the urethra (tip of penis) with enucleation and removal of prostatic tissue
- Robotic or open simple prostatectomy: This involves surgical removal of the obstructing part of the prostate either through a small incision or via robotic-assisted laparoscopy
Schedule an appointment with a MidLantic Urology physician near you today!