Enlarged Prostate/BPH in The Treasure Valley
Benign Prostatic Hyperplasia (Prostatic Enlargement)
Benign Prostatic Hyperplasia (BPH) is the non-cancerous enlargement of the prostate that most men will face as they age. The prostate gland encircles the urethra and produces a fluid that makes up most of the volume of the semen. As the prostate increases in size, it can put pressure on the urethra that may cause many symptoms such as slowing of the urinary stream, feeling of incomplete emptying of the bladder, trouble starting a urine stream, stopping and starting several times during urination, and urinating often, especially at night. It can also cause urinary retention – blockage that results in the inability to urinate.
BPH symptoms may vary from person to person and may change over time. For some, BPH never progresses beyond mild to moderate symptoms that are somewhat annoying. Some men may choose to do nothing and pursue a “watchful waiting” course of action, while others may find relief with prescription medications and/or lifestyle changes. Yet for others with more severe symptoms that have a greater impact on their quality of life and well-being, surgical treatment may be an option.
Complications from BPH may include:
- bladder or kidney infection
- weakened bladder
- hematuria (blood in the urine)
- renal failure
- bladder stones
Diagnosing BPH
A diagnosis of BPH involves a physical exam, a digital rectal examination (DRE) and an evaluation of the patient’s symptoms.
Laboratory tests may include:
- Prostate specific antigen (PSA) to help screen for prostate cancer.
- Urinalysis and culture to rule out kidney disorders and urinary tract infections.
- Blood urea nitrogen (BUN) and creatinine blood tests to evaluate kidney function, which may be compromised if the prostate is causing urinary obstruction.
Diagnostic tests may include:
- Bladder and prostate ultrasound to measure the size of the prostate and determine the amount of urine retained in the bladder.
- Cystoscopy to evaluate the urethra and bladder with a small flexible scope.
- Prostate biopsy to rule out prostate cancer.
Treatment Options for BPH
Treatment choices will also vary from patient to patient. Your physician will discuss the pros and cons of each treatment option and will help you decide which course of treatment will provide the most optimal benefit based on your symptoms.
Lifestyle Changes/Behavioral Therapy
May include reducing fluid intake in the evening and removing bladder irritants from your diet.
Medications for those with moderate symptoms
- Alpha blockers relax the muscles around the prostate and bladder neck and usually begin to provide relief quite quickly.
- 5-alpha reductase inhibitors shrink the prostate gland in men whose prostate volume is over 40 cc. These medications may take months to work.
- Anticholinergics are used to delay the urge to urinate and inhibit involuntary bladder contractions.
Minimally Invasive Therapies
- UroLift Procedure – prostatic urethral walls are “tented” open, done as an outpatient procedure.
Surgical Treatments
- Transurethral resection of the prostate (TURP) is a procedure to remove tissue from the prostate. During TURP, a very thin lighted tube with a cutting tool at the end is inserted through the urethra. Prostatic tissue that is causing blockage is cut away and removed. This procedure is frequently used to treat moderate to severe BPH. Depending upon the situation, this may be an outpatient procedure or may require an overnight stay.
- Transurethral incision of the prostate (TUIP) uses special cutting instruments inserted through the urethra. TUIP differs from TURP in that no prostate tissue is removed. Instead, one or two small cuts or grooves are made into the prostate gland where your prostate meets your bladder. The cuts cause the urethra to expand, thereby making it easier to urinate. Depending upon the situation, this may be an outpatient procedure or may require an overnight stay.
- Open prostatectomy is usually done for those who have a greatly enlarged prostate gland, bladder damage or other complicating factors, such as bladder stones or urethral narrowing. This is an inpatient surgery.
BPH FAQ
What Causes BPH?
It is not perfectly clear as to what leads the prostate to grow larger and larger during a man’s life. Significant growth during puberty is expected and completely normal, though research shows that the prostate again begins slowly increasing in size from age 25 and continues throughout the man’s life.
Who Is at Risk for BPH?
Since gradual prostate growth is consistent among a large majority of men, it is extremely common for this condition to be diagnosed in those of an older age. Statistically speaking, BPH affects:
- 20% of men over 50
- 60% of men over 60
- 70% of men over 70
- 90% of men over 80
In addition to age, other risk factors include having a family history of BPH, being obese, leading a sedentary lifestyle that does not include regular exercise, having type 2 diabetes, and experiencing erectile dysfunction.
How Does The board-certified urologists Diagnose BPH?
Men typically have the health of their prostate evaluated during yearly physical examinations with their physician. This simple screening is often able to detect superficial abnormalities of the prostate, such as unusually large sizing.
Patients who schedule a consultation with The board-certified urologists regarding BPH will begin by thoroughly discussing their symptoms, personal medical history, and family medical history. A physical evaluation is often performed as well, and additional diagnostic tests may be ordered to analyze the functionality of the patient’s urinary system.
Do I Have to Undergo Treatment for BPH?
Not necessarily. Some patients may elect to hold off on treating their enlarged prostate and instead choose to monitor the progression of their symptoms over time. Idaho Urologic Institute will typically suggest more frequent checkups at Idaho Urologic Institute to regularly assess the health of the prostate and determine if the patient’s BPH is worsening.
While men can choose to avoid treating their BPH, it is highly encouraged to speak with a specialist about treatment options if symptoms caused by the condition are negatively affecting daily tasks and activities.
What BPH Treatments Are Available in Meridian, Boise & Nampa?
Lifestyle changes and medications are often the first options recommended for men that experience mild symptoms caused by BPH. Reducing liquid intake, avoiding stimulants, and practicing pelvic floor strengthening exercises can all help patients regain a bit more control over their urinary functions, while some forms medications have shown to slow or completely stop the growth of the prostate.
Through new technological advancements within the healthcare industry, there are many minimally invasive procedures available to men suffering from more considerable urinary difficulties. These include:
- Transurethral microwave therapy
- High-intensity focused ultrasound (HIFU)
- Rezūm™ Water Vapor Therapy
- The UroLift® System
In some instances, The board-certified urologists may suggest surgery to offer patients with a more complex case of BPH to achieve effective relief from their symptoms. These traditional surgical procedures include transurethral resection of the prostate (TURP) as well as transurethral incision of the prostate (TUIP). Given The board-certified urologists’ unique expertise in using the da Vinci Surgical System, it is possible to avoid open surgery in favor of minimally invasive techniques.
What Can Happen If BPH Is Left Untreated?
Most patients will not experience severe complications caused by an enlarged prostate. However, it is entirely possible for BPH to lead to daily dysfunctions in a man’s life as he struggles to manage worsening symptoms, or for this condition to lead to significant damage to the kidneys, urinary tract, or bladder.
Is BPH Related to Prostate Cancer?
No. Because BPH is a benign condition, its symptoms have absolutely nothing to do with cancerous cell growth of the prostate.
