BPH, or benign prostatic hyperplasia, affects about 50 percent of all men over the age of 50 and 80 percent of men over 80.

The prostate (walnut-size gland underneath a man’s bladder that produces seminal fluid) typically grows as men age. The pressure and muscle tightening caused by BPH can compromise bladder and urethra functions.

Complications are fewer when BPH is found in its early stages. Severe BPH can cause serious problems over time: urinary tract infections, bladder or kidney damage, bladder stones, and incontinence.

Symptoms
• Hesitant, interrupted, weak stream
• Urgency and leaking
• Frequent urination, especially at night

Diagnosis
A physical exam and symptom evaluation usually are all that is needed to diagnose BPH. DRE, Digital Rectal Exam, in which the physician inserts a gloved finger into the rectum and feels the prostate, is usually the first test performed to give the doctor an idea of the size and condition of the gland.

Other tests include urine flow study, in which a reduced flow suggests BPH; and cystoscopy, where a lighted tube inside the bladder helps determine the size of the gland and the location of the obstruction.

Treatments

Medication
In some cases, drugs can shrink the prostate or reduce growth. Other medications act by relaxing the muscle of the prostate and bladder neck to reduce bladder obstruction and improve urine flow.

Non-Surgical Procedures
Because drug treatment is not always effecttive, researchers have developed a number of procedures that relieve BPH symptoms but are less invasive than surgery. These procedures take about an hour to perform in the doctor’s office or outpatient surgery and present few complications.

Transurethral Microwave Procedures (TUMT) applies microwaves through a catheter that heats and destroys excess prostate tissue (office).

Transurethral Needle Ablation (TUNA) delivers low-level, radio-frequency energy through needles to burn away regions of enlargement (hospital).

Surgery
Surgery is a traditional approach to BPH treatment. It requires anesthesia and a hospital stay and carries more risk than other treatments.

Transurethral Resection of the Prostate (TURP) makes up 90 percent of all surgeries for BPH. A scope is used to remove obstructing tissue.

Open Surgery requires an external incision. It is used in the few surgical cases where the transurethral procedure cannot be used, such as when the gland is greatly enlarged, there are complications, or the bladder has been damaged and needs repair.

Old Pueblo Urology
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