Reconstructive Urology & Men's Health

Prostate Enlargement - BPH

The prostate is a male gland that surrounds the urethra (urinary channel) near the bladder. Its main role happens during the fertility years, since the prostate makes much of the fluid that comes out during ejaculation. It grows as men age and may start to cause partial or complete blockage of the urinary stream. This can cause a variety of symptoms (see below), ranging from “obstructive” (slow stream, incomplete bladder emptying) to “irritative” (urgency to void, voiding multiple times at night). The bladder, which works harder and harder to get the urine out, may start to become abnormal over time.

If you are worried about the condition of your prostate or have some uncomfortable symptoms, the urologists at the reconstructive urology clinic can help you determine the cause and suggest treatment options. Our urologists have particular expertise in the transurethral resection of the prostate and laser prostate treatments.

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Enlarged Prostate or BPH

Also known as benign prostatic hypertrophy (BPH), prostate enlargement is NOT the same as prostate cancer, which is also common in men but usually does not cause urinary symptoms until it has been present for a long time. There is also a link between erectile dysfunction (ED) and BPH although no one is entirely sure why that is. We know that if one is treated, the other often gets better also.

Symptoms

Prostate enlargement symptoms may include:

  • Urinary frequency (day or night)
  • Urinary urgency (a stronger urge than usual to urinate); if this is very strong, the patient may even have incontinence.
  • Urinary hesitancy (difficulty initiating the urination) or straining to urinate
  • Incomplete bladder emptying: this may be just a feeling or it may be the case that the bladder is retaining too much urine
  • Weak or “stuttering” urinary stream

Diagnosis

There are many tools to evaluate how severe the problem is and how we may best fix it. Some common ones include:

  • Questionnaires, such as the international prostate symptom score (IPSS)
  • Ultrasound to determine whether the bladder is emptying
  • Rectal examination to evaluate the size and texture of the prostate
  • Blood tests including PSA (the level of a chemical made by the prostate)
  • Cystoscopy (looking inside urinary channel with a small camera)

Treatment of Enlarged Prostate

Treatment depends on a number of factors, including how severe the symptoms are, the size of the prostate, whether bladder is normal or abnormal and others. If the patient is not very bothered by the symptoms, often they do not require any treatment other than a periodic visit to make sure things aren’t getting worse.

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