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Treating BPH

There are both medical and surgical treatments for BPH.  Many are very effective but all have side effects.  Your doctor will discuss various treatments appropriate for your symptoms coincide with other test results.

Drug Treatments

Medications for treating an enlarged prostate center around both shrinking the prostate and relieving some of the symptoms.  These medications are very effective for many men and side effects are usually minor and somewhat uncommon.   Let’s outline some of the medications.

Alpha Blockers: These work by relaxing the muscles around the prostate and bladder neck so urine can flow more easily.  They work quickly and improvement is seen in a day or two.  Alpha blockers were originally made for treating high blood pressure, so side effects include dizziness, headache, stomach irritation and stuffy nose.  Examples of these drugs are Flomax, Uroxatral, Hytrin and Cardura.

5-Alpha Reductase Inhibitors: These drugs work to shrink the prostate by reducing levels of a male hormone called DHT.  These drugs take longer to work but improvement is generally seen after 3 months.  Examples of these drugs are Proscar and Avodart.

Surgery Options

If medication is not effective, surgery might be necessary.  There is a variety of procedures today that address problems of different severities.

TURP – Transurethral Resection of the Prostate has long been the standard for removing the inner core of the prostate that presses on the urethra.  A small wire loop is inserted through the urethra at the penis allowing the loop to remove the part of the prostate causing problems. Men require a catheter for about 2 days and are hospitalized for that period.

TUIP – Transurethral Incision of the Prostate is a similar operation, but instead of removing parts of the prostate, small incisions are cut to reduce pressure.

Laser Prostatectomy – There are several types of laser surgery.  Some are technically difficult but others can be done in a clinic setting.  Though laser surgery is not the best choice for everyone, your doctor may see it as an advantage.

Transurethral Thermotherapy – This uses microwave energy to heat prostate tissue while not harming other tissue around it.  Though is less invasive, it is thought to also be less effective.  Re-treatment might be necessary.

Transurethral Electrovaporization – This procedure vaporizes and coagulates (clots) prostate tissue so that no bleeding or absorption occurs.  A catheter remains for 1 day and men are hospitalized for that period.

Managing Incontinence

Some men have incontinence before and after treatments and can range from mild to moderate urine loss.

At First Quality® we realize the social implications of urinary incontinence. Therefore, we have designed products to be thin,
discreet and still highly absorbent.

These products are ideal for wearers on the go. Prevail® Bladder Control Pads are available in a variety of absorbencies from the very light Prevail® Pantiliners, to the new Prevail® Ultimate with added absorbency.

First Quality® has also developed an absorbent incontinent pad designed for men only. Prevail® Male Guards are designed
specifically for men with stress or urge incontinence. They are individually wrapped for discreet and convenient protection.

Regardless of your situation, talk to your doctor to make sure you understand your condition and the treatments presented.  Make a list of questions before you go to your appointment so that you have all of the information.  Be very clear about your symptoms when describing them.

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Could I have BPH (Benign Prostatic Hyperplasia)?

First and Foremost, talk to your doctor or health care provider about your symptoms.  They are the best avenue for clarifying what might be wrong.

You might also find the “AUA scoring test” of interest.  The AUA (American Urological Association) Score or Symptom Index is a self-administered questionnaire used to determine how severe symptoms may be. It asks seven questions related to common symptoms of BPH and asks you to rate the degree of frequency or severity on a scale of 1 to 5. A total AUA Score of 0 to 7 is considered mild; 8 to 19 is rated moderate, and 20 to 35, severe.  The link to this site is :

http://godot.urol.uic.edu/%7Eweb/ASIS.html

How is BPH diagnosed?

To determine if you have BPH, your doctor may recommend one or more of the following tests:

Physical Exam

Your doctor will likely begin with a physical exam and blood/urine tests.  A digital rectal exam where the doctor will gently insert a gloved finger into the rectum to feel the prostate is routine.  Blood testing for PSA (prostate-specific antigen) and a urinalysis to rule out infection and other problems are also customary.

X-rays and Ultrasound

Ultrasound can help to estimate the size of the prostate.  It can also detect kidney obstructions, stones in the kidney, or tumors on the prostate.   An x-ray called an Intravenous Pyelogram is a procedure where dye is injected into a vein, then x-rays are taken of the kidneys, bladder and ureters.  It is another way to detect stones, tumors and other blockages.

Uroflow

Usually performed in your doctor’s office, the uroflow test determines how quickly and completely you can empty your bladder. With a full bladder, you will be asked to urinate into a special measuring device. A reduced flow may indicate BPH.

Pressure Flow Study and Post Voice Residual testing

Theses tests measure pressure in your bladder and how much urine is left in the bladder after you urinate.  Both require the insertion of a catheter through the penis and into the bladder. While the catheter is uncomfortable, many doctors recommend them to determine the extent of urinary blockage.

Next month:  Treatments for BPH and how to manage incontinence.

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