This September marks Urology Awareness Month and Healthy Aging Month, and what better way to kick off this health holiday than by talking about a urological problem that is primarily caused by age – the enlarged prostate, or benign prostatic hyperplasia prostate (BPH); You’ll notice that we discuss BPH quite a bit on our website, and that’s because it’s one of the most common urological issues affecting men over the age of 40 or 50. Although the name says it all – BPH is benign – it can cause significant symptoms that can significantly change a person’s life and lifestyle. Because it’s such a normal part of aging and men are often reluctant to see their urologist about it, many are limited in their activities because they worry about the possibility of urine leakage or urinary urgency, among other symptoms.
However, there are many options to start the process toward a life free of CFS symptoms. Most urologists, including Dr. Natale, are committed to offering their patients a step-by-step approach to managing lower urinary tract symptoms associated with BPH. This often starts with lifestyle changes through improved diet and exercise. If these don’t work or patients can’t maintain a healthier lifestyle, some try herbal remedies like Saw Palmetto with decidedly mixed success. There is no solid clinical data showing that saw palmetto or any other herbal remedy significantly affects BPH symptoms. While we don’t necessarily try to dissuade our patients from pursuing these options, we do warn them of potential safety and efficacy issues associated with the less regulated world of supplements that we often and jokingly call the Wild West.
That said, when lifestyle changes and medications fail to help patients with lower urinary tract symptoms, we turn to the myriad of procedural options available to treat UTI. Once again, we start with the least invasive options, which usually consist of in-office treatments that can be performed in anywhere from 5 to 15 minutes and require only an office visit. One of the most popular, for example, is the Rezum steam treatment, which uses steam to destroy excess prostate tissue, which is then absorbed into the body over the next four to six weeks. During this absorption process, symptoms improve and this, along with other in-office treatments, can be effective for up to five or even seven years. Other procedures, such as the Urolift, do not mechanically remove prostate tissue.
What happens then?
Of course, we know patients hear these numbers and wonder what will happen at the end of the effective time period. Eventually, the prostate tissue grows back and lower urinary tract symptoms will start again. This is a virtual certainty for any operation other than those that remove the prostate entirely, which we do not routinely do unless, for example, aggressive prostate cancer is found alongside BPH. Patients will be pleased to know that many of these procedures can be performed a second or even third time. Each time they are executed, it resets their timer and gives them many more years of relief. These in-office procedures are so successful that patients often return when they start experiencing symptoms in the future, requesting the procedure by name.
A warning for older patrons
Significantly larger prostates may require a different method of treatment. Typically, in-office BPH treatments cannot effectively treat a very large enlarged prostate. And here, we have options to help these patients get relief. One such option is a simple prostatectomy, which involves surgically hollowing out the prostate, leaving only the capsule. HoLEP, or holmium laser surgery, is a laser-based version of this procedure that uses focused light to burn the tissue inside the prostatic capsule. A third and recent option that has shown benefit in larger prostates is Aquablation, which uses a semi-autonomous robot and a directed stream of water to remove excess tissue. These options have varying degrees of effectiveness and must be tailored to the patient’s circumstances.
The bottom line
In the world of BPH, there are many options for patients of all body types. By seeing an experienced urologist like Dr. Natalie, who has extensive experience with many of these procedures, you are assured of the most effective and safe approach for your case.
It is important to realize that you do not have to live with the lower urinary tract symptoms associated with BPH and that there are effective and safe options for you. The first step is to call us and schedule a consultation to learn more about your prostate enlargement and what we can do.
