As men age, their prostate gland can grow larger, putting pressure on the bladder and urethra, the vessel that carries urine from the bladder and outside of the body. This is known as benign prostatic hyperplasia or BPH. It is one of the most common health problems men can experience, affecting half of all men between 51 and 60 years of age, and 90% of men older than 80.
In some cases, it can lead to painful urination, reduced sex drive, erectile dysfunction and urinary continence or retention (the inability to urinate). Most men with BPH are unhappy with the condition and do not wish to live the rest of their lives with its symptoms, which typically include:
- A frequent or urgent need to urinate (especially at night)
- A weak urine stream
- Difficulty beginning urination or dribbling at the end
- Inability to completely empty the bladder
BPH is also linked to erectile dysfunction and reduced sex drive. Left untreated, it can lead to urinary tract infections (UTIs), bladder damage, bladder stones, kidney damage (or chronic renal failure) and urinary retention (the inability to urinate).
What happens as the prostate gets bigger?
The prostate is a gland that is normally the size of a walnut. With BPH, it can grow as large as a tennis ball. The enlarging prostate can put pressure on the urethra, which carries urine out of the body. This can restrict the flow of urine or, in extreme cases, cut it off completely.
Treatment Options
Men with mild BPH symptoms may be treated with lifestyle changes, medication or supplements. Your doctor may also ask you to avoid taking certain medications like decongestants or certain antihistamines that can affect your prostate.
Severe BPH symptoms may be treated with transurethral resection of the prostate (TURP), a surgical procedure that requires anesthesia. Unfortunately, side effects are common with TURP procedures and include infection, bleeding and a loss of erections. 65 out of 100 men who have the surgery will experience retrograde ejaculation, a condition where semen goes into the bladder and not out of the penis. Another complication of TURP is painful or difficult urination, which is ironically one of the problems the surgery is meant to fix.
UroLift® is a less invasive procedure that some urologists now offer as an alternative to TURP. It uses permanent implants to lift the enlarged prostate away from the urethra. This has the effect of reducing pressure on the urethra and improving urine flow. While UroLift is shown to alleviate the symptoms of BPH, it does not address the underlying condition of the enlarged prostate. As a result, symptoms can return. In fact, it is estimated that approximately 12% of UroLift patients will require another procedure within two years.
A new and minimally invasive procedure cleared by the FDA in 2018, known as prostate artery embolization (PAE), is an excellent treatment option for men with severe BPH symptoms. This convenient outpatient procedure performed by our doctors may alleviate BPH symptoms for most men without the need for surgery. Unlike UroLift, it addresses the root cause of the problem (the growing prostate). Also, unlike UroLift, it is the only minimally invasive procedure shown to improve sexual performance.