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U.S. News and World Report: America's Best Hospitals, Urology, 2014-2015

 

Benign Prostatic Hyperplasia (BPH)

UW Health's urologists offer state-of-the-art treatment for men with benign prostatic hyperplasia (BPH).
 
Benign prostatic hyperplasia is a non-cancerous enlargement of the prostate gland that affects more than 26 million men each year in the United States.
 

UW Health Urologist Dan Williams, MD discusses Benign Prostatic Hyperplasia (BPH)

Causes of BPH
 
With age and time, the prostate naturally enlarges, which can cause pressure on the urethra and interfere with the normal flow of urine. By age 60, half of all men have an enlarged prostate. By age 80, about 80 percent of all men have an enlarged prostate. 

The prostate forms part of the male reproductive system and helps produce semen. It is located at the base of the male bladder. The prostate surrounds the urethra, the canal which carries urine from the bladder out of the body, and produces fluid that transports sperm during ejaculation.

The prostate grows to a normal size in teenage years, and then begins to grow again around the age of 50. The exact cause of BPH is unknown.
 
Symptoms of BPH
  • Dribbling after urinating
  • Inability to urinate (urinary retention)
  • Frequent urination
  • Incomplete emptying of your bladder
  • Incontinence
  • Nocturia (waking up frequently at night to urinate)
  • Pain with urination or bloody urine (these may also indicate urinary tract infection)
  • Slowed or delayed start of the urinary stream
  • Straining to urinate
  • Strong and sudden urge to urinate
  • Weak urine stream
It can be embarrassing to discuss these symptoms, however, if left unchecked, an enlarged prostate can progress to bladder dysfunction or kidney failure. If you experience any of the above symptoms, you should consult with your physician.
 
Diagnosis of BPH
 
Men may not experience any symptoms and still have an enlarged prostate. It is also possible that the common urinary tract symptoms are related to a problem with the bladder and not just the prostate.
 
Your urologist will conduct a physical examination and other tests to help determine the underlying cause of your symptoms.
 
An enlarged prostate does not necessarily indicate prostate cancer, however, your urologist may run routine screening tests (PSA) as part of the initial evaluation.
 
Treatments for BPH
 
For men with an enlarged prostate, there are medical and surgical treatments available.
 
Depending on your individual condition, your urologist may recommend beginning with oral medication to try and manage the symptoms of the enlarged prostate.
 
For men who experience side effects from the oral medication, or in cases when the pills are not effective, surgical management of the prostate may be indicated.
 
Surgical Treatment for BPH
 
There are a number of different surgical treatments for an enlarged prostate.
 
Transurethral Resection of the Prostate (TURP)
 
Transurethral Resection of the Prostate (TURP) is a surgical treatment for men with urinary syptoms due to an enlarged prostate.
 
During the surgery, a portion of the prostate tissue is removed through the urinary tract without an incision. A short hospital stay is generally required.
 
Laser Surgery for BPH
 
Laser surgery is a modern alternative to the traditional TURP. It is a minimally invasive procedure that has less bleeding, lower side effects and a quicker recovery time for most men.
 
During laser surgery, laser energy is used to remove the obstructing prostate tissue and open a channel for urine flow from the bladder through the urethra. Typically, this surgery is performed on an outpatient basis, or with a short overnight stay.