Prostate, Benign Disease


Benign prostatic hyperplasia, or BPH, is a condition which affects many men, Over 80% of men over the age of 50 will have evidence of prostatic enlargement, up to 50% will experience some symptoms, and up to 25% may require some form of treatment or suffer side-effects from this problem.

The prostate gland itself is a structure that is found at the base of the bladder which surrounds the urethra. Its normal function is to contribute to the formation of semen. When the prostate enlarges, it can narrow the urethra with obstruction to the flow of urine. Symptoms of prostate enlargement include diminished urine flow, frequent urination, nocturia (getting up at night to void), straining to urinate, sense of incomplete emptying of the bladder, and urgency (need to void quickly). More significant problems associated with prostatic obstruction include infection (prostatitis), bleeding, inability to urinate, development of bladder stones, or even kidney failure. When these later problems develop, or when the earlier symptoms become especially bothersome, treatment of prostatic enlargement may be recommended.

Evaluation of a man with prostatic enlargement is generally done in the office setting. History taking and physical examination are the most important evaluations, but sometimes other studies are indicated. Blood testing (Prostate Specific Antigen, PSA) is often done to evaluate for possible cancer. Non-invasive studies such as bladder and kidney ultrasound and urinary flow studies are sometimes recommended. More involved testing could involve prostatic ultrasound, cystoscopy (looking into the bladder) and urodynamics (to assess bladder pressure during voiding). All of these studies are done by Central Arizona Urologists in our offices.

When symptoms of prostatic enlargement are significant enough, treatment may be recommended. The “gold standard” for therapy has always been surgery via the procedure called a TURP (transurethral resection of prostate). This was perhaps the first “minimally invasive” operation. It is done through a cystoscopy rather than an incision.

Now there are several non-surgical treatments for prostatic enlargement. Several medications are now available to treat BPH. Alpha blockers and 5-alpha reductase inhibitors are two of the medicine classifications offered for select patients, in addition to a broad range of herbal medications (phytotherapies) which are being pursued by patients (often independent of their urologist). Another newer modality for treating BPH is the use of microwave energy to heat and subsequently shrink the prostate. The results with high-energy protocols appear promising, and again this a “non-surgical” treatment.

The physicians at Central Arizona Urologists are experts in the evaluation and treatment of BPH and offer a full range of treatment options, including medical therapy and microwave treatments .

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