Enlarged Prostate

For reasons not entirely known, men’s prostate gland, that walnut sized organ at the base of the bladder that surrounds the urethra or the tube that allows urine to pass from the bladder to the outside of the body, grows and impacts a man’s quality of life.  By the time you reach the age of 60, you have a 50/50 chance of having an enlarged prostate. When you celebrate your 80th birthday as most men will if they take good care of themselves, you can expect to have urinary symptoms related to your pesky prostate  gland.

The symptoms that occur with the enlarged prostate gland include: a weak or interrupted urinary stream, urgency to urinate, frequent urination, inability to completely empty the bladder during urination, trouble initiating urine flow even when bladder feels full and perhaps the most troublesome of all is getting up at night to urinate.

While these are most common, you may have an enlarged prostate and still not experience any of these.  It’s safe to say that after the age of 40, you will want to keep a dialogue with your physician about your prostate health as well as receiving full exams.

The evaluation consists of a careful history, a physical examination, and a few tests such as a urinalysis and a PSA test or prostate specific antigen, which is a blood test that screens or checks for prostate cancer.

Men experiencing minimal symptoms of BPH may choose to practice what is called watchful waiting. This means to simply monitor your condition on an annual basis until changes warrant treatment.

For over 50 years the gold standard of treatment was transurethral resection of the prostate gland or (TURP). In this surgery, often euphemistically referred to as the “rotor router” treatment, the inner portion of the prostate that is obstructing urine flow is removed. The results are improvement in urination and a decrease in frequency of urination, night time voiding, and improvement in the force of the urine stream….kind of like turning the clock back to when you were in 20s and 30s!  However, this treatment required hospital admission, a general anesthetic, a catheter or tube for a few days, and complications such as bleeding, infection, and an absence of ejaculation, and rarely impotence or erectile dysfunction.

Since 1980 there are medications that either relax the muscles in the prostate or shrink the prostate gland.  These medications are also associated with complications including sexual side effects.

Since 2010 there is a minimally invasive treatment, UroLift, that opens the prostate gland, reduces the obstruction, improves urinary symptoms, and has NO sexual side effects.

If you would like more information on the management of the enlarged prostate gland, please go to my website, www.neilbaum.com.  Also, if you call my office, I can provide you with a video of the UroLift minimally invasive treatment of the enlarged prostate gland.


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