BPH with LUTS/Enlarged Prostate

Benign prostatic hyperplasia, or BPH, is quite common and involves the enlargement of a man’s prostate gland as he ages. He can have trouble urinating, causing a number of lower urinary tract symptoms (LUTS). Symptoms may include:

Urgency – having the pressing need to urinate
Frequency – feeling that you need to urinate more often than usual
Incomplete emptying of bladder
Awaking many times during the night to urinate

Advanced Urology Centers of New York has helped thousands of men with this problem, and if you think you are suffering from BPH, we can help you, too. Below are some of the tests that an AUCNY urologist may order to diagnose conditions and determine the best treatment.

Blood tests– including Prostate-specific antigen (PSA) and other tests to determine the cause of BPH symptoms
Digital Rectal Exam (DRE)– checks to see if the prostate is enlarged, whether there is cancer or other health issues exist.
Transrectal Ultrasound– provides images and measurements of the size and shape of the prostate. It can find abnormal growths in the prostate.
Urine Test– used to rule out infection as the reason for existing symptoms
24-hour Voiding Dairy– provides the AUCNY caregivers with urine output information with the amounts and time of day of bathroom trips
Postvoid Residual Volume Test– Shows whether you can completely empty your bladder
Urinalysis– checks for infections, blood, proteins, and other issues that can give information about your symptoms
Urinary Flow Study– Checks the strength and volume of your urine flow
Cystoscopy– a procedure that allows your doctor to inspect your urinary tract including the bladder and urethra
MRI’s and CT’s– if surgery is needed, these tests may be ordered to see the prostate and surrounding areas around it.
Prostate Biopsy– a procedure that uses a needle to remove a small sample from the prostate gland to check for prostate cancer. This is done if there is a high PSA blood test result or abnormal digital rectal exam.

Treatment Options

Medications prescribed:
Men who are experiencing moderate to severe BPH with LUTS (enlarged prostate) symptoms may be treated with medications such as alfuzosin (Uroxatral), doxazosin (Cardura), silodosin (Rapaflo), tamsulosin (Flomax) or terazosin (Hytrin), which are part of a class of medications known as alpha-blockers. These treatments work by relaxing the muscles around the bladder allowing an easier flow of urine.

Minimally invasive surgery performed:

Greenlight™ Laser:
A laser is used to quickly heat and evaporates the prostate tissue that is blocking the bladder opening. The procedure is usually performed under general anesthesia and typically provides patients with symptom relief after the procedure.

Rezum™ Water Vapor Therapy:
Water vapor energy ablation shrinks the enlarged prostate using steam to remove the extra tissue that is pushing on the urethra. This non-surgical treatment is done in the office. Most patients see improvement of their symptoms within two weeks.

Transurethral Microwave Therapy (TUMT):
This procedure uses a small antenna that applies microwave energy to heat and destroy the extra enlarged prostate tissue which is blocking the urine flow.

Transurethral Needle Ablation (TUNA):
Radiofrequency waves are used to heat and destroy the enlarged prostate tissue. This procedure improves urine flow to provide symptom relief.

Transurethral Resection of the Prostate (TURP):
With the use of an electric current or laser light, TURP cuts away the extra enlarged prostate tissue. This procedure is usually a treatment for men with moderate to severe urinary problems who did not improve from medication therapy.

Urolift® System:
Serial suture implants are used to constrict the enlarged prostate tissue so that the urethra is no longer blocked. These serial sutures are placed facing each other from the lateral to the medial side of the prostate along the course of the urethra, narrowing the thick tissue bilaterally and widening the passageway. This minimally invasive procedure can usually be performed in our offices in under one hour and patients are able to go home the same day.

Surgical options:

Prostatectomy:
For very severe cases of enlarged prostate, AUCNY physicians perform a partial or complete removal of the obstructing prostate gland through a surgical incision.

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BPH with LUTS/Enlarged Prostate

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