Many men experience increased difficulty with urination as they age. Benign prostatic hyperplasia (BPH), which is noncancerous growth of the prostate, is one of the foremost causes of urinary problems in men, and is one of the leading reasons why men present to the urologist. Symptoms from BPH can include urgency and frequency of urination, getting up at night to urinate and a slow stream. Men will often tell stories about how their urinary symptoms affect their everyday lives. For instance, delivery men and postal workers will often describe how they know the location of every bathroom on their route. Urinary symptoms from BPH don’t just impact quality of life, they be a sign of a serious, underlying problem.
Complications of BPH can include development of bladder stones, urinary tract infections, bleeding (hematuria), and urinary retention which could possibly lead to kidney injury or even failure.
At Yale Urology, we are experts in the evaluation and treatment of BPH. An initial evaluation of a man with BPH will also aim to identify other contributing factors. Underlying health issues such as diabetes, heart disease and use of medications such as diuretics may also be the cause of urinary symptoms. In addition, behavioral and social factors such as caffeine or alcohol consumption may be adding to the problem. The prostate is examined to assess the size and to help rule out underlying prostate cancer. The bladder can be assessed to see if it is emptying adequately.
If the urinary symptoms of BPH are mild, behavioral modification such as timed voiding and counseling patients to eliminate certain dietary factors such as caffeine and alcohol may be beneficial. If symptoms are moderate or severe, it may be recommended to start medication such as an alpha blocker, which relaxes the prostate and often is very effective in reducing BPH symptoms within a few days. Five-alpha reductase inhibitors are another class of medication used to treat BPH. These medications may take several months to take effect but are useful in decreasing the size of the prostate and reducing the risk of developing urinary retention or requiring surgery.
Surgical intervention may be necessary for those patients that have developed complications of BPH or who have not had a good response to medications. At Yale Urology, we offer state of the art surgical treatment of BPH, including Urolift and Holmium laser enucleation of the prostate (HoLEP). The Urolift procedure can often be performed in the office without anesthesia, and offers a speedy recovery and durable improvement in urinary symptoms. HoLEP is a minimally invasive surgery which can treat prostates of all sizes with minimal bleeding, and often can be performed in an ambulatory setting.
If you or a loved one is experiencing difficulty with urinating, you can make an appointment for further evaluation with a Yale urologist by calling (203) 785-2815.