Benign Prostatic Hyperplasia (BPH)

Definition

Benign Prostatic Hyperplasia (BPH) also known as lower urinary tract symptoms (LUTS), is a common urological condition caused by the non-cancerous enlargement of the prostate gland in aging men. As the prostate enlarges, it can squeeze down on the urethra. This can cause men to have trouble urinating leading to the symptoms of BPH.

Risk Factors

• Age-symptoms are rare in men under 40, but about one-third of men experience some symptoms by sixty and half experience symptoms by eighty
• Family history/genetics- those with an immediate family history of prostate issues are more likely to also have problems
• Ethnic background- Prostate issues are more common amongst African-American men followed by Caucasian men and then Asian men
• Diabetes and heart disease

Symptoms

Symptoms of BPH vary depending on the individual, but tend to worsen over time. Common symptoms include:
• Frequent or urgent need to urinate
• Increased frequency of urination at night
• Difficulty starting urination
• Weak urine stream or interrupted urination
• Dribbling at the end of urination
• Straining while urinating
• Inability to completely empty the bladder

Diagnosis

Multiple tests can be performed to help confirm a diagnosis of BPH and to exclude more serious conditions. These include:.
• Digital rectal exam
• Urine test
• Blood Test
• Prostate-specific antigen (PSA) blood test
• Neurological exam
• Urinary flow test
• Post-void residual volume test
If your condition seems to be more serious, other tests may also be performed.

Treatment Options

There are a wide range of treatment options for BPH including medications, minimally invasive therapies done through telescopes without the need for incisions on the body, or traditional open surgeries. If you have the symptoms listed above, make sure to speak with your doctor to determine the best course of action.

Laser Resection of the Prostate

TURP may be performed with a laser in procedures called photoselective vaporization of the prostate (PVP) or holmium laser enucleation (HOLEP). Laser therapy lessens the bleeding risks of traditional TURP. However, since prostate tissue is still removed, there can be tissue swelling and an uncomfortable healing time. Typically, a catheter has to be inserted into the bladder after the procedure.

Transurethral Resection of the Prostate (TURP)

TURP is the most common surgery to treat BPH. During this procedure, patients undergo general anesthesia, and prostate tissue is removed. TURP is often considered the “gold standard” for long-term results.

After prostate tissue has been removed, the body needs time to heal. The remaining prostate tissue may actually swell and become inflamed before the desired shrinking effect occurs. Patients may suffer an uncomfortable recovery period that includes short-term problems such as bleeding, infection, erectile dysfunction, and urinary incontinence. Patients have to have a catheter that is attached to a urine bag inserted into their bladder for several days after the procedure.

Symptom relief may not occur immediately, but lasts for a long time in many patients once it does occur.

There can be long-term side effects after TURP such as dry orgasm (retrograde ejaculation), erectile dysfunction or incontinence (leaking of urine).

Thermotherapies are minimally invasive treatments where heat energy such as microwave or radiofrequency is applied to destroy prostate tissue. Less invasive than TURP, these treatments are generally safe, can be performed under local anesthesia and provide moderate symptom relief for some patients.

Applying high heat to the prostate can cause tissue swelling and uncomfortable urinary symptoms during the healing period. Symptom relief does not occur immediately, and patients often need to have a catheter that is attached to a urine bag inserted into their bladder during the recovery period.

The UroLift® System treatment is a minimally invasive approach to treating BPH that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. Clinical data has shown that the UroLift System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without any impact to sexual function.

Advantages of the UroLift System:

  • Rapid symptom relief, better than reported for medications2
  • Risk profile better than reported for surgical procedures such as TURP3
  • Preservation of sexual function1
  • Return to normal activity in days not months
  • Increased quality of life
  • No ongoing BPH medications
  • 19 clinical study publications; 4 years published clinical data4

How the UroLift works:

The UroLift System treatment is a straightforward procedure that is performed by a urologist. The urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. The UroLift System treatment can be done in the physician’s office under local anesthesia. Typically, patients return home the same day without a catheter.

BPH- Before and After Document

BPH Patient Brochure

Enlarged Prostate: An enlarged prostate compresses on the urethra, making it difficult for urine to flow
Step 1: The UroLift Device is placed through the obstructed urethra to access the enlarged prostate.
Step 2: Small UroLift Implants are permanently placed to lift and hold the enlarged prostate tissues out of the way and increase the opening of the urethra. The permanent implants are delivered through a small needle that comes out of the UroLift delivery device and into the prostate.
Step 3: The UroLift delivery device s removed, leaving an open urethra designed to provide symptom relief.

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