Urology

Patients

The prostate is a walnut-shaped gland that is part of the male reproductive system. It is located below the bladder and surrounds the urethra. The urethra is the tube that transports urine from the bladder out of the body. The main function of the prostate is to supply fluid that carries semen.

As a man ages, his prostate enlarges. As the prostate enlarges, it can squeeze the urethra and result in symptoms that irritate or obstruct urine flow.

• Enlarged prostate, or BPH (benign prostatic hyperplasia), affects over 14 million men in the US
• BPH occurs in approximately half of all men 50 years and older and up to 90% of men over 80 years of age

BPH is the non-cancerous enlargement of the prostate that restricts urine flow. BPH is not usually life threatening but you may have found it to be embarrassing, inconvenient and uncomfortable. Symptoms of BPH include the need to urinate often, the need to urinate suddenly, difficulty emptying your bladder completely, and difficulty sleeping due to frequent urination.

When these symptoms impact your quality of life by impairing your ability to sleep and participate in daily activities you should consider seeking treatment.

In order to help determine the severity of your condition, your physician may ask you to complete the American Urological Association (AUA) Symptom Score questionnaire. Your numerical score on the AUA Symptom Score questions can range from mild to severe. The higher your score, the more severe your condition.

Score Severity:
0 – 7 Mild
8 – 19 Moderate
20+ Severe

In addition, your physician may use the following to diagnose and better understand your BPH:

• Physical exam
• Blood and urine tests
• Ultrasound imaging

Treatment Options:

1-Non Surgical Options:

• Drugs – Medication or prescription drugs are a common treatment option for BPH. Drugs address the symptoms of BPH but do not cure the disease. Symptom relief can cease when you stop taking the drugs. Medication can be costly and some BPH drugs may interfere with other medications you are taking. Potential side effects may include impotence, dizziness, headaches and fatigue.
• Microwave therapy – This in office procedure relies on microwave energy to heat and treat prostate tissue.
• Holmium Laser Treatment (also known as HoLAP – Holmium Laser Ablation of the Prostate) uses laser energy designed to alleviate BPH symptoms and reduce some of the traditional complications associated with surgery. Patients may experience immediate symptom relief, little, if any, bleeding and may be released the same day without a catheter

• Transurethral resection of the prostate or TURP is the standard surgical procedure to remove the prostate. With the patient under anesthesia, a cystoscope is placed into the urethra, allowing the doctor to view the bladder and prostate. An electrical loop is inserted into the cystoscope and used to cut the tissue into small pieces, one at a time. The tissue pieces collect in the bladder and are then flushed out with irrigating fluid. Some bleeding during and after the procedure is common. After the procedure, a catheter is inserted into the bladder and continuously irrigated with fluid to monitor bleeding and prevent catheter obstruction

While TURP has been proven effective, some complications exist. The hospital stay is 1-3 days and you may have to return home with a catheter in place. The catheter may be attached to a leg bag and removed several days later. TURP complications include blood loss and transfusion, impotence, incontinence, infection and retrograde ejaculation (dry climax). Typical recovery time is 4 - 6 weeks.