BPH / Enlarged Prostate

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BPH/Enlarged Prostate: 

Benign prostatic hyperplasia, or BPH, refers to the non-cancerous enlargement of the prostate gland, the gland which surrounds the urethra and produces the fluid that carries sperm during ejaculation. Prostate enlargement happens to almost all men as they get older. Prostate enlargement is typically accompanied by symptoms such as: frequent or urgent urination, nighttime urination, weak urinary stream, and difficulty starting urinary stream.

Treatments may include:

NON-SURGICAL TREATMENT

  • Lifestyle modifications: We often believe the most conservative course of action is best to try first, unless circumstances warrant a more aggressive approach. There are some simple steps you can take without medications or procedures that can improve your BPH-related urinary symptoms, including changing bathroom habits and dietary changes.
  • 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

Office Based Outpatient Procedures

  • UroLift:  A minimally invasive procedure that treats patients suffering from an enlarged prostate. This treatment technique is incredibly unique because it does not require cutting, heating, or the removal of prostate tissue. Instead, the UroLift system utilizes tiny implants to hold the prostate lobes apart, increasing the opening of the urethra. A catheter is not typically placed in the urethra after the procedure. Many patients report complete symptom relief in as little as two weeks.
  • Rezūm:  Rezūm is FDA approved and uses thermal energy to treat the excess prostate tissue that causes symptoms such as frequent and urgent need to urinate, weak stream, irregular flow, and straining.  Benefits of Rezūm include a noticeable improvement of symptoms an as little as two weeks, no need for general anesthesia, preservation of urinary and sexual function, and ability for patients to return to regular activities in just a few days.
  • Optilume: minimally invasive surgical therapy combines mechanical dilation with concurrent localized delivery of paclitaxel for treating BPH. Mechanical dilation with the proprietary double-lobe balloon technology achieves an anterior commissurotomy (split) releasing the constricting lateral lobes, while the delivery of paclitaxel prevents re-fusion of the lobes and maintains patency during healing. NO CUTTING. NO HEATING. NO BURNING. NO LASERING. NO STEAMING. NO IMPLANTATION!
  • iTIND: new minimally invasive treatment which takes 5 to 7 days with immediate results. The treatment gently reshapes the urethra, widening the opening through which urine can flow. The iTind procedure does not cause any of the side effects associated with prescription medications, and initial studies have shown that it preserves sexual function and urinary incontinence and avoids complications that are typically associated with major surgery. Some patients experience side effects during the procedure, but they are generally only mild to moderate and resolve once the device is removed. Unlike other non-surgical BPH procedures, the iTind involves no heating or removal of prostate tissue, and no permanent implant is left behind

Surgical Treatment Options 

  • Aquablation: Utilizing the precision of robotics, while harnessing the power of water, Aquablation uses high-pressure saline to remove excess prostate tissue present in BPH patients to relieve the pressure that the prostate has placed on the urethra and possibly the bladder. Aquablation is a one-of-a-kind procedure that has demonstrated low rates of irreversible complications, such as urinary incontinence, erectile dysfunction, and ejaculatory dysfunction, compared to published rates observed for other resective surgeries
  • Transurethral Resection of the Prostate (TURP):  Transurethral resection of the prostate (TURP) is a minimally invasive procedure that treats moderate to severe cases of benign prostatic hyperplasia. For many years, this procedure was considered the most effective treatment option for patients suffering from an enlarged prostate. While there are a number of newer therapies on the market today, TURP continues to be a popular treatment technique for patients with BPH.  This procedure is advantageous for patients not wanting to undergo an extensive surgical procedure because TURP requires no incisions be made outside the body
  • GreenLight Laser PVP (Photoselective Vaporization of the Prostate):  A minimally invasive procedure that treats benign prostatic hyperplasia (BPH) using high-powered lasers to vaporize overgrown prostate cells.  There are many benefits to GreenLight laser PVP over other BPH procedures. For example, the laser seals off blood vessels, causing less bleeding than other BPH treatment options. Patients are also able to resume normal activity levels within three to five days after the procedure, with a full recovery occurring in four to six weeks.

Prostate Artery Embolization (PAE): minimally invasive treatment that helps improve lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH). BPH is a noncancerous enlargement of the prostate gland and is the most common benign tumor found in men. The PAE procedure is performed by an interventional radiologist (IR), a doctor who uses X-rays and other advanced imaging to see inside the body and treat conditions without surgery.

Robotic Simple Prostatectomy:  A minimally invasive procedure that removes the inner core of the prostate gland. This surgery is usually performed on patients with prostate glands that are more than three times the normal size. Other factors that may lead to a robotic simple prostatectomy include extremely slow urination, frequent bleeding from the prostate, bladder stones, kidney damage, and frequent urinary tract infections (UTIs).  Recovery from robotic surgery is usually well tolerated and results in less pain, minimal blood loss, and less down time. Patients will need to use a catheter for several days after the procedure to help encourage safe urination.

HoLEP:  Holmium Laser Enucleation, or HoLEP, of the prostate, is a minimally invasive procedure to treat an enlarged prostate.  This procedure removes excess tissue with a laser, eliminating blockages and allowing urine to flow through the prostate.  HoLEP offers several advantages to traditional prostate surgery, including no limit to prostate size before treatment, less bleeding, quicker discharge and recovery, and a lower chance of recurrence needing additional surgery.