Millions of middle age men suffer from non-cancerous prostate gland enlargement. The cause is not known but is probably related to hormonal changes that occur normally in men after age 50.
The symptoms are going to the bathroom frequently, urgency of urination, poor stream, dribbling after urination. However, the most bothersome symptom that impacts a man’s quality of life is getting up multiple times during the night to go to the restroom.
Though the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties, and as many as 90% in their seventies and eighties, have some symptoms of BPH. Moreover, because drug treatment is not effective in all cases, researchers in recent years have developed a number of procedures that relieve BPH symptoms but are less invasive than conventional surgery.
Thus, BPH is an age-related condition like many others, such as memory deficiency, reduced bones density and muscles flexibility.
As for natural treatment options, it has been noted Saw palmetto, a popular herbal therapy among men with prostate symptoms, is not effective and more and more scientific studies are showing that saw palmetto has no benefits in the treatment of BPH.
There are oral medications such as alpha-blockers such as Flomax and Rapaflo that relax the muscles in the prostate and make it easier for the bladder to empty the contents from the bladder. There are also medications that reduce the size of the prostate gland. These drugs, Proscar and Advodart, actually help decrease the size of the prostate thus decreasing the resistance to the flow of urine from the bladder to the outside of the body. Unfortunately, these drugs have mild side effects and since so many Americans are polymedicated, and alternative solutions are often more attractive to active middle aged men.
Minimally invasive treatments
Men with enlarged prostate glands have symptoms of going to the bathroom frequently, dribbling after urination, and getting up at night to go to the bathroom. The problem is usually caused by a benign enlargement of the prostate gland, which blocks the flow of urine from the bladder to the outside of the body. The cause of the benign enlargement is not known but is probably related to alternations in the hormones, testosterone, of middle aged and older men. Treatment usually consists of medications, alpha-blockers and medications to actually relax the muscles in the prostate gland but these are often ineffective especially if used for long period of time. The other options include minimally invasive procedures such as microwaves that can actually shrink the prostate gland. Now there’s a new treatment option that can be done in the doctor’s office under a local anesthetic.
What are some of the minimally invasive treatments available for BPH?
Laser vaporization: Anesthesia is usually required for this procedure, but patients can usually go home the same day. The technology involves placing a “cystoscope” (metal tube through which the visual lens and laser can be passed). A laser is used to burn and vaporize the obstructing or blocking prostatic tissue. Studies to date have shown limited long-term benefits.
Microwave thermotherapy of the prostate (TUMT): This is an office-based procedure performed with topical and oral pain medication and does not require a general anesthesia. Computer-regulated microwaves are sent through a catheter to heat portions of the prostate. A cooling system is required in some types for better tolerance. Traditionally, the best use of this procedure has been for patients who have too many medical problems for more invasive surgery or for patients who truly wish to avoid any type of anesthesia. Benefits are that there is no need for anesthesia and there is no blood loss or fluid absorption (these would be significant benefits in a person with a weak heart). Patients usually go home the same day. Men may need a catheter for one or two days after the procedure.
The UroLift system, made by NeoTract Inc. of Pleasanton, Calif., is the first permanent implant to relieve low or blocked urine flow in men age 50 and older with an enlarged prostate.
By pulling back prostate tissue that presses on the urethra, the system allows more natural urine flow. This procedure is compared to pulling back the curtains with a sash. The procedure can be done in the doctor’s office under a local anesthetic and will actually open up the urethra to allow the flow of urine and reduce the urinary symptoms of frequency of urination, improve the force and caliber of the urine stream, and decrease the number of times a man needs to get up at night to empty his bladder.
Of course with any procedure there may be side effects and complications. Some b patients reported pain or burning during urination, increased urgency, decreased urine flow, incomplete bladder emptying, and blood in the urine. Most of these symptoms and side effects were temporary and resolved a few days or weeks after the UroLift was performed.
Bottom Line: Millions of American men suffer from symptoms as a result of an enlarged prostate gland. Certainly medications are a first line treatment option. However, the UroLift may be a permanent solution to this common problem and help men get a good night’s sleep!