Benign prostatic hyperplasia, or BPH, is the most common cause of urinary issues in men. There are now many ways physicians can treat BPH, including behavioral modifications, medications, and minimally invasive surgical procedures. Like many things, the first step to treating any medical condition is letting your doctor know you're having issues.
The prostate is a relatively small gland located in front of the bladder. Urine flows from the bladder through the prostate via the urethra, or urine channel. BPH creates an obstruction to this flow, causing urinary difficulty. BPH is sometimes referred to as an enlarged prostate, and while men with larger prostates tend to have urinary trouble, the actual size of the prostate does not always correlate to the degree of urinary difficulty.
BPH becomes more prevalent as men age
It is very common for men to develop urinary trouble related to BPH as they age. 50 percent of men over 50 years of age will experience BPH, and this number increases by 10 percent with each decade of life. There are many signs and symptoms of BPH, including:
- Weak urinary stream
- An intermittent urinary stream (frequently stops and starts)
- Urinary urgency and frequency
- Dribbling after you’ve finished urinating
- A sensation that your bladder is not emptying completely (incomplete emptying)
- Getting up at night to urinate (nocturia)
- Taking time to begin urinating (hesitancy)
Both BPH and prostate cancer become more common with age. These conditions are not one in the same or even necessarily related, but they can occur simultaneously. It’s important to talk to your doctor about prostate cancer screening, regardless of your urinary symptoms.
Ways of treating BPH
Even though BPH can be a normal part of aging, it’s not something you have to live with. There are now many options to treating BPH and the resulting urinary problem, including oral medications and minor, minimally invasive, outpatient surgical procedures. Additionally, there are a number of things you can do at home to try to help improve symptoms.
- Behavioral Modification:
There are personal things you can do to decrease the incidence of BPH by making simple modifications to your daily routine, like:
- If your main issue is getting up at night to urinate, simply reducing your fluid intake a few hours before bed (and making sure you empty your bladder right before bed) can help.
- If you have issues with leg swelling, propping your feet up a few hours before lying down for bed can help get the fluid out of your system and prevent waking you up at night to urinate.
- Avoid bladder irritants such as spicy foods, sugary foods and drinks, caffeine, and alcohol. These can all irritate the bladder, making urinary urgency and frequency worse.
- Assess your medicine cabinet. Some over-the-counter medications such as antihistamines and decongestants can affect the prostate, making it more difficult to urinate.
- Prescription Medication:
- There are two main categories of prescription prostate medications: those that help to “relax” the prostate and open the prostate channel, and those that physically shrink the prostate.
- These are common and relatively inexpensive medications, taken once daily and sometimes prescribed together. They typically have very few minor side effects, but it’s important to discuss this and review your current medications with your doctor. There are also several supplements that typically include Saw Palmetto as the main ingredient. While certainly not harmful, many studies have proven that Saw Palmetto does not show any clinical improvement compared to placebo.
- Minimally Invasive Surgical Procedures: Through the West Jefferson Urology Department, there are a few outpatient surgical procedures available for men whose symptoms do not resolve with the above treatments, or for men who prefer more definitive treatment without the need for additional medication.
- Urolift: a quick (usually less than 10 minutes) minimally invasive, outpatient procedure done under a light anesthetic, where tiny implants are placed into the prostate with a camera to help relieve obstruction and improve urinary flow. Men see improvement immediately and rarely need a catheter in the post-operative period, unlike other prostate surgeries.
- Laser Photo Vaporization of the Prostate (PVP): Minimally invasisve, this procedure consists of high-frequency energy from a laser used to ablate prostate tissue, creating an open channel.
- Transurethral Resection of the Prostate (TURP): in a similar fashion, obstructing prostate tissue is resected using a camera and minimally invasive cautery equipment.
About Dr. Matthew Strain:
Dr. Matthew Strain earned his medical degree from LSU Health Shreveport in 2013. He then completed his general surgery internship and urologic surgery residency training at the University of Tennessee Health Sciences Center in Memphis, TN.
Dr. Strain is certified by the American Board of Urology. His special interests include minimally invasive surgery, urologic cancers, kidney stone disease, BPH/enlarged prostate, urinary incontinence, and men's health.
A native of Mandeville, Dr. Strain is glad to be back in South Louisiana serving the New Orleans area as a member of West Jefferson Urology Specialists, which he joined in 2018. He currently serves as a member of the American Urological Association, AUA Southeast Section, and Louisiana Urologic Association.