One of the most common reasons that men see an urologist is for the evaluation and management of urinary symptoms from enlarged prostate. Symptoms often include weak stream, hesitancy of urination, frequency and urgency of urination, getting up frequently at night to urinate, and the sensation of poor emptying of the bladder.
The cause of BPH symptoms generally is the growth of the prostate which occurs over a man’s lifetime. Usually, symptoms do not start until a man is in his 50’s, but most men will suffer from some symptoms as they age.
The first step in the process is to rule out other things that could be causing problems such as prostate cancer, bladder cancer or urinary tract infection. The evaluation will include history, physical exam of the prostate and lab tests to include PSA and urinalysis. Initial recommendations might include a trial of medications such as Flomax (tamsulosin) or Rapaflo, noninvasive tests such as ultrasound or urine flow test. Depending on a patient’s evaluation and response to first line treatments, a cystoscopy (looking inside the bladder) may be indicated.
If medications don’t improve symptoms, there are many options that may be considered. In general, all surgical or procedural options for BPH “open” the prostate. When men have very large prostates, or certain anatomy, the best option is usually to resect or cut the prostate open (TURP or TransUrethral Resection of the Prostate). Recent improvements in this technology have allowed us to do “saline TURP” which has distinct advantages. When the prostate is modestly enlarged, with favorable anatomy, other options can be considered. In these cases, Greenlight Laser Vaporization of the Prostate (GVP) can be used as a less invasive option for BPH. Urolift may also be a good option for patients, and was recently FDA approved.
For men with moderately enlarged prostates, minimally invasive treatments are an option.
Greenlight Laser Vaporization of the prostate is also very effective. The key to success is patient selection. The advantages of this procedure include a less invasive procedure with lower risk of bleeding, and no overnight hospital stay. The catheter usually only stays in overnight. Risks include infection, bleeding, dry orgasm, scar tissue and urgency/frequency of urination. Dr. Neeb has performed over 200 of these procedures.
UroLift® System is a new, minimally invasive approach to treating BPH for patients looking for an alternative to drug therapy or more invasive surgery. The UroLift System is a straightforward procedure that utilizes tiny implants to lift and hold the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
Clinical data has proven that the UroLift System treatment is safe and effective and can improve BPH symptoms 3 to 4 times greater than with medication. Results have shown durability to two years with no impact to sexual function. The goal is to relieve you of bothersome urinary symptoms so you can get back to your life and resume daily activities.
Dr. Andrew Neeb is the first urologist in Oregon to perform the UroLift procedure.
There are other treatment options for BPH, and these can also be discussed with your doctor. If you have questions about BPH treatment in the Bend, OR area, contact Urology Specialists of Oregon at (541) 322-5753.
Hello Dr. Neeb,
I have noticed less urgency issues now, they are not as strong and powerful as they were a few weeks ago. I can hold them off a time or two without breaking a sweat and without worrying about peeing my pants. When I finally decide to go, I have a full stream and can empty my bladder a lot faster than I was ever able to prior to the Urolift. I can even bear down some and gain more pressure, which was something I could not do before.
I was skeptical of it at first because of the very strong urgency, but you told me during the procedure that would happen, and you were correct. Since the issue of urgency has subsided, I am really enjoying the Urolift and am seeing the benefits. Thank you so much, it has made a real difference in my life.
Hope you don’t mind but I have been providing other men I work with your name in case they get serious about considering the Urolift!
Thank you again Dr. Neeb!