Enlarged Prostate (BPH)
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What Is an Enlarged Prostate?

The prostate is a gland in the male body that produces some of the reproductive fluid. An enlarged prostate is a term we used to refer to this gland when it has become larger than usual. While it is typical for the prostate to grow over time, some conditions can cause it to swell at an abnormal rate, usually indicating some illness or disease is present.

What Is BPH?

While a simply enlarged prostate is often referred to as benign prostatic hyperplasia, this is technically not always the case. Cases of BPH may include an enlarged prostate, but not every enlarged prostate is necessarily BPH.

This is because BPH is a condition that can cause many different symptoms, including an enlarged prostate, frequent urination, difficult urination, weak urine stream, urinary tract infections, inability to urinate entirely or bloody urine.

What Is BPH?

What Causes These Conditions?

Unfortunately, we aren’t entirely sure what causes the prostate to enlarge, but modern medicine has been able to pinpoint some potential risk factors that may increase its likelihood: aging, diabetes and heart disease, family history, and certain lifestyle factors like obesity.

  • Aging — Men younger than 40 rarely develop enlarged prostates or BPH, but by the age of 60, about one-third of all men experience moderate to severe symptoms. This number increases to half by the age of 80.
  • Diabetes and Heart Disease — There are some studies that indicate these two common conditions can increase the likelihood of developing enlarged prostates.
  • Family History — While research is still developing, it would appear that having a family history of enlarged prostates increases the likelihood of developing symptoms yourself.
  • Lifestyle — Obesity or a sedentary lifestyle increases your chance of developing BPH or an enlarged prostate.

How Do We Treat Them?

There are three steps to the treatment process: diagnosis, advanced testing and treatment.

Diagnosis

When you present symptoms to our team that could indicate BPH or an enlarged prostate, we will run several initial tests to determine a diagnosis. Urine tests, blood work and a rectal exam are the most common. The blood work will usually include a prostate-specific antigen test.

Some of the less common tests to have conducted are a urinary flow test, postvoid residual volume test and a 24-hour voiding diary that will track the frequency and amount of your urinations.

Advanced Testing

In some cases, more complex cases of BPH or enlarged prostates may include more extensive testing, such as:

  • transrectal ultrasound, a procedure where a probe is inserted into your rectum to view the prostate;
  • prostate biopsy, which includes taking a tissue sample of the prostate;
  • urodynamic and pressure-flow studies, designed to determine bladder muscle strength;
  • cystoscopy, a tiny instrument inserted into your urethra to examine the urethra and bladder.

Treatment

Three categories of treatments are available, depending on your unique conditions and how your body responds to each method. We generally recommend beginning with conservative medications or minimally invasive procedures before moving into surgery. Still, in some severe cases, surgery may be the best course of action immediately.

Medications

Alpha Blockers  — This medication relieves the symptoms of the condition without addressing the condition itself. They offer nearly immediate improvement (24 - 48 hours) and work well for men with mild to moderate prostate enlargement.

5-Alpha Reductase Inhibitors  — By reducing the amount of dihydrotestosterone, commonly known as DHT, these drugs can potentially reduce the size of the prostate and relieve symptoms. While this medication focuses on the root of the problem, it can take between six and 12 months to take effect.

Minimally Invasive Procedures

Prostatic Stents  — These are small metal coils that are inserted into the urethra to keep the opening widened. It is performed under local or spinal anesthesia and is generally only done on people who are either unwilling or unable to use medications or have surgery.

Generally, there are some risks to having a stent performed, such as frequent infections or the dislodging of the stent itself, causing worsened symptoms. They are also typically more expensive and less reliable than other methods of treatment.

TUMT — Transurethral microwave thermotherapy is the application of concentrated heat into the prostatic tissue. A cooling system is used to protect surrounding tissue from damage. This process destroys part of the swollen gland to correct the blockage and alleviate some of the symptoms. It can help with urination frequency and flow, but it cannot fix issues pertaining to bladder expulsion.

TUNA — Transurethral radiofrequency needle ablation is similar to TUMT, except that the heat is applied by inserting small needles into the targeted area that emit high-frequency radio waves. Some anesthesia is used, but minor pain and discomfort may occur for a few weeks after the procedure is completed.

Surgeries

turp — Transurethral re-sectioning of the prostate is the most common surgery for an enlarged prostate or BPH because it is believed to provide the greatest improvement to a patient’s symptoms. The process includes cutting off tissue with an electrical loop that seals blood vessels and prevents excessive bleeding.

TUIP — Also known as “transurethral incision of the prostate,” this procedure requires that cuts are made to the prostate instead of the removal of tissue. The small cuts reduce pressure on the urethra, improving urination and other symptoms. TUIP involves similar risks to TURP, like retrograde ejaculation or erection concerns.

Open Prostate Surgery — This procedure may be conducted in some cases where surgery cannot be performed through the urethra. Generally, it is not preferred since it requires an incision through the abdomen. Once inside, however, the surgeon can remove tissue from the prostate and relieve the patient from excessive pressure and blockage.

Laser Surgery — Typically performed under general anesthesia, this method uses a high-energy vaporizing laser to remove tissue from the prostate. Relief is immediate, but painful urination for a few weeks after the procedure is standard because of the nature of the treatment.

Why Choose VIP?

Why Choose VIP?

At VIP, we are a team of five highly skilled medical professionals who have been extensively trained in the kinds of conditions you are experiencing. We have developed a reputation for taking on the most severe cases that need the most acute treatment — and we are highly successful in those complex cases.

Many of us have served as professors and educators to the medical community, and we practice only with the most cutting-edge treatments and techniques available to the field. We look forward to continued service to the greater Phoenix area at our facility.

Find Relief at VIP in Phoenix, AZ

If you are ready to relieve your pain and get back to the life you once had — without worrying about painful, frequent or difficult urination — then give our office a call at (480) 435-9100. You can also complete our online contact form to have a staff member call back as soon as possible.

We know that the thing you need the most during this time is a trusted friend and guide through the process, and we look forward to filling that role as much as possible. Bring all your questions and concerns to your consultation so we can provide you with all the information you need.

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