Benign (non-cancerous) enlargement of the prostate is commonly referred to as "BPH". The symptoms related to this condition usually develop gradually and include frequent urination, difficulty starting the stream, slow urinary flow, dribbling at the end of urination, and having to get up a lot a night to urinate.
Benign Prostatic Enlargement
Copyright (C) 2019 Steven A. Johnson, M.D., P.A.
Men with BPH should routinely have their prostate examined and should have a PSA blood test to identify any risk factors to suggest prostate cancer. However, BPH does not cause prostate cancer.
There are many medications available to treat BPH effectively. One type, alpha blockers, relax the tone of the prostate so that the urine can pass more easily and freely. Hytrin (terazosin) and Cardura (doxazosin) are available in generic forms but may cause an undesirable lowering of blood pressure. Flomax, Rapaflo, and Uroxatral are more specific for the prostate and less likely to cause side effects. Another type of drug, known as 5-alpha reductase inhibitors, actually shrink the physical size of the prostate. These drugs, Proscar (finesteride) and Avodart, work more slowly than alpha-blockers. However, they have been shown to lower a man's future risk of needing surgery for BPH. Studies have actually shown that using an alpha-blocker and a 5-alpha reductase inhibitor together is the most effective non-surgical way to treat BPH.
The most traditional and most successful way to treat advanced BPH is TURP and suprapubic prostatectomy. Both surgical procedures remove the obstructing prostate tissue. TURP stands for transurethral resection of the prostate. During this procedure, a scope is passed through the penis and the internal prostate tissue is shaved out using a special instrument. Suprapubic prostatectomy is a more traditional surgery where an incision is made below the naval and the obstructing prostate tissue is removed by hand. The American Urological Association recommends that suprapubic prostatectomy be considered if a man has a prostate larger than 80 grams.
In the last 10 years, there has been a proliferation of technologies developed to treat BPH without traditional surgery. These include Urofit microwave therapy (TUMT), radio frequency ablation (TUNA) and laser vaporization of the prostate.
Urolift is one of the latest office-based procedures approved by the FDA or the treatment of BPH. During the procedure, a specially -designed scope is inserted into the penis. This scope allows the urologist to visualize the prostate while simultaneously deploying a series of pledgets that tack the prostate open to allow optimal flow of urine through the gland. The appearance of the urinary channel through the prostate following Urolift closely resembles the appearance of the prostate following TURP.