Enlarged prostate: What is it and what are your options?
It’s not unusual for men to need more frequent bathroom breaks as they get older. This can be a sign of a condition called benign prostatic hyperplasia (BPH), also known as enlarged prostate.
BPH affects an estimated 70 percent of US men aged 60 to 69 and a whopping 80 percent of men over 70. When the prostate becomes enlarged, urine has trouble passing through the urethra — the tube that urine travels through — out of the body.
Common symptoms of BPH include:
- An increased need to urinate urgently
- Needing to go frequently at night
- A bladder that never feels completely empty
- A weak stream
“The decision to treat symptomatic BPH depends on whether the symptoms impact quality of life,” says Kevin Tsai, MD, a MultiCare urologist. “Typically for mild or moderate cases of BPH, management with lifestyle modifications or medications to relax or shrink the prostate may be started and overseen by the PCP.”
However, if symptoms are more severe or don’t respond to medications, your provider may refer you to a urologist like Dr. Tsai to explore other options.
The standard treatment until recently — transurethral resection of prostate (TURP) — involves an instrument that “shaves” the prostate tissue and is typically done in an operating room, requiring full anesthesia.
But a new option for treatment is a less invasive in-office procedure called Rezum,TM which uses targeted water vapor injections to shrink prostate tissue without the need for incisions or general anesthesia. Research studies have shown Rezum improves urine flow and relieves symptoms for at least five years.
“A patient with poor heart or lung function may be at risk for anesthesia complications and may not qualify for this surgery,” Dr. Tsai says. “It may also not be safe for patients on blood thinners or who have bleeding disorders to undergo this surgery.”
In addition to anesthesia and bleeding risks, one potential side effect of the traditional surgery is diminished or absent ejaculation after climax. By comparison, water vapor therapy can help keep normal ejaculation function intact.
During the Rezum procedure, local anesthesia is used before passing a camera through the urethra to the prostate. Then, the doctor uses targeted injections of heated water vapor, which takes around nine-seconds per injection. Typically, around five to seven injections are performed, so the procedure time is only a few minutes.
Results won’t be immediate, Dr. Tsai cautions.
“The steam injections heat the prostate tissue to a specific temperature that causes the tissue to gradually release over a period of three months,” he says. “This reduces congestion within the urinary channel through the prostate, resulting in improved urinary flow and bladder emptying.”
Whether it’s water vapor therapy, medication or traditional surgery, Dr. Tsai says the most important thing to remember is that help is available, and you have options.
So, if spending more time than you used to in the bathroom is not a normal part of aging you can accept, talk to your primary care provider (PCP) today.
