Benign Prostatic Hyperplasia (BPH)
Benign prostatic hyperplasia (BPH) is a common type of noncancerous tumor that leads to enlargement of the prostate gland in men. Common symptoms include lower urinary tract issues, such as increased urination, poor urinary flow and the urgent need to urinate.
BPH Symptoms and Diagnosis
BPH is the most common type of prostate issue that affects men over 50. Although the exact cause is unknown, BPH can be treated through medication, lifestyle change, minimally invasive procedures or surgery.
Common symptoms of BPH include:
- Difficulty starting urination
- Increased urination, especially at night
- Poor urinary flow
- The urgent need to urinate
- Trouble emptying the bladder completely
Benign prostatic hyperplasia is typically diagnosed through:
- A physical exam
- Urine tests
- Blood tests to detect prostate-specific antigens (PSA), a protein that can be affected by benign prostatic hyperplasia.
- Cystoscopy, which allows the doctor to see inside the body with a thin, lighted, flexible tube called a cystoscope.
Treatment at BIDMC
Several treatments for BPH are available. The type of treatment you’ll receive will depend on the severity of your symptoms, how the symptoms affect your quality of life, as well as your personal preference.
Typical treatments include:
- Prescription medication –Typically, medications are used when symptoms do not significantly impact the patient’s quality of life.
- Prostate surgery – The most common type of surgery used to correct an enlarged prostate is transurethral resection of the prostate (TURP). The surgery involves inserting a tool, known as a resectoscope, into the tip of the penis and using an electric current to cut and remove tissue and cauterize blood vessels.
- Prostate artery embolization (PAE) – PAE is a type of minimally invasive treatment that shrinks the prostate by affecting the blood vessels. An interventional radiologist can perform this procedure as an alternative to surgery.
About Prostate Artery Embolization (PAE)
PAE can be an alternative to TURP or other urological procedures. PAE can be performed without general anesthesia and is a safe, effective, and relatively painless treatment.
The procedure involves creating a pin sized hole in the wrist or groin and inserting a long catheter into the artery that supplies blood to the prostate. From there, an interventional radiologist inserts beads to shrink the prostate gland which allows the patient to urinate without issue. On average, PAE shrinks the size of the prostate by approximately 30-50% over the course of the year following the procedure, which eases urinary symptoms, increases the quality of life, and prevents sexual dysfunction.
Side effects are generally short lived and mild. They usually include mild pain and/or a burning sensation as well as blood in the urine.
To determine whether you’re a candidate for PAE, your doctor will go over your medical records and complete a comprehensive evaluation of your current health. If you’re a candidate, we will contact your insurance company for authorization to move forward with the procedure.
About Prostate Surgery
Transurethral resection of the prostate (TURP) is the current standard treatment for BPH. The surgery is performed under general anesthesia and takes about an hour and a half to complete.
TURP involves placing a rigid metallic scope through the penis and into the prostate gland to trim any problematic tissue. Once the tissue is cut, it travels to the bladder where it remains until a surgeon removes it at the end of the operation.
Urinary symptoms are relieved very quickly after TURP. The surgery generally requires a short hospital and up to six weeks of recovery time. Side effects may include pain, bleeding, sexual dysfunction, and, in some cases, difficulty controlling your bladder. If you experience any side effects that impact your quality of life, your doctor can recommend a variety of treatment options, such as medication.