Benign prostatic hyperplasia (BPH) is a benign (non-cancerous) enlargement of the prostate gland in men. As men age, the cells that make up the prostate gland increase in number, causing the prostate to grow which can cause bothersome urinary symptoms.
Symptoms
Typically, symptoms occur in men after the age of 40, when the prostate starts to enlarge. Symptoms can range from mild to severe, or even with the inability to urinate. Typically, symptoms include some of the following:
- Difficulty urinating
- Weak urinary stream
- Straining to urinate
- Sudden urges to urinate
- Sensation of needing to urinate immediately after urinating
- Starting and stopping the urinary stream
- Urinating at night
- Leaking urine
Often, a man’s feelings about symptoms guide their doctor to recommend treatment. Some men may have a large prostate but no urinary symptoms, and treatment can wait. Other men may have severe urinary symptoms that impair their quality of life but a smaller prostate gland, and would benefit from treatment.
Testing
If you experience urinary symptoms, the prostate may be the cause. Testing typically involves a prostate examination, PSA blood test, urine study (urinalysis), and measurement of bladder emptying. Additionally, if treatment is an options, often cystoscopy and prostate size are evaluated.
Cystoscopy
Cystoscopy is a medical procedure that allows your doctor to inspect the urethra and bladder. During the procedure, your doctor will insert a small scope into your urethra, the tube connected to the bladder. The scope acts as a telescope to examine the inside of your urethra and bladder. Sometimes this scope may have a camera attached allowing the procedure to be displayed on a screen.
Immediately prior and during the procedure, a lubricating and numbing jelly is often used to allow easy passage of the scope.
Typically, cystoscopy takes 1-5 minutes to complete depending on the reason for the examination.
Transrectal ultrasound of the prostate (TRUS)
TRUS is a procedure where a small ultrasound probe is used to measured the size of the prostate gland to determine the size of the prostate. Your doctor will place a small ultrasound probe into the rectum, visualize the prostate, and measure the prostate to determine total size and ensure no abnormalities are present.
Procedures
Various medications and procedures can be used to treat BPH. Often, procedures are based on the patient’s symptoms, prostate size, and appearance of the prostate during evaluation.
Medications
There are two main types of medications to treat BPH. Your doctor may evaluate and recommend one or both as treatment for your urinary symptoms.
UroLift
UroLift is a revolutionary minimally-invasive procedure used to hold the enlarged prostate tissue open so it no longer blocks the tube (urethra) that urine flows through. The procedure is typically done under sedation and takes less than 30 minutes. Sexual function is typically preserved, and men are often able to stop medications they had been taking for urinary symptoms.
Transurethral resection of the prostate (TURP)
Transurethral resection of the prostate (TURP) is a procedure where a small telescope and a laser or electronic loop is used to remove obstructing prostate tissue from blocking the urethra. The procedure is typically done under general or spinal anesthesia and requires a catheter afterwards to drain the bladder.