What is the PROSTATE?
The prostate is a gland in the male urinary tract that produces fluids that are emitted into the semen during ejaculation. The prostate resides between the bladder (which stores the urine) and the urethra (which carries the urine out). At its endmost (most distal) aspect where the prostate meets the urethra, resides the urinary sphincter (a special muscle which helps us keep the urine in the bladder).
What is BPH?
BPH, or Benign Prostatic Hyperplasia, is a non-cancerous overgrowth of the prostate gland, which affects the flow of urine out of the bladder and into the urethra. BPH (benign prostatic hyperplasia) affects men as they grow older, and upwards of 12 million men in the U.S. suffer from its symptoms. According to Dr. Kamyar Ebrahimi, urologist in Glendale CA, “some of the symptoms of BPH (benign prostatic hyperplasia) can initially be attributed to the growth of the prostate, which can restrict and impede the flow of urine out.” Thus the patient feels as though they are not able to empty their bladder completely when urinating. Furthermore, BPH (benign prostatic hyperplasia) can cause other urinary problems such as stopping and restarting of the stream (urinary hesitancy), need to urinate urgently (urinary urgency), need to urinate at night (nocturia), weaker urinary stream, and the need to urinate over and over again (urinary frequency).
Why should men take BPH symptoms SERIOUSLY?
While for the most part BPH (benign prostatic hyperplasia) symptoms are not life threatening, they can have a significant and profound negative effect on a man’s life and those who live with them. Difficulty with obtaining a restful night’s sleep is the biggest complaint of men affected by BPH (benign prostatic hyperplasia), as well as their partners. Furthermore, if left untreated, BPH (benign prostatic hyperplasia) may result in urinary retention (inability to void), urinary tract infection (UTI). More seriously, longstanding BPH (benign prostatic hyperplasia) may cause irreversible damage to the bladder and its ability to contract appropriately (an action which is paramount to bladder’s function to expel the urine), and even kidney damage, due to increased back pressure of urine into the kidneys called hydronephrosis. Kidney failure is a serious and life threatening condition, and may lead to hemodialysis.
While at least in the beginning and for the most part BPH (benign prostatic hyperplasia) symptoms are the result of prostatic enlargement, there could be other reasons for these symptoms. Dr. Ebrahimi, who is a fellowship trained urologist in endourology and robotic urologic surgery believes that “only a urologists can determine if BPH (benign prostatic hyperplasia) is causing your symptoms or if it is from some other urological conditions and rule out other diseases such as bladder or prostate cancers that could present the same way.”
Treatment of BPH
Most men seek treatment because of bothersome urinary symptoms which affect them and their partner. The goal of BPH (benign prostatic hyperplasia) treatment is to reduce the severity of the symptoms and to restore normal function of the urinary system. If the symptoms are mild, Dr. Ebrahimi believes that your doctor may recommend watchful waiting. This can be accomplished with a few simple steps and behavioral modifications.
When the symptoms are bothersome, Dr. Ebrahimi believes that oral medications could be recommended as the first line of therapy for BPH (benign prostatic hyperplasia). Two classes of medications are typically recommended. The first medication class is called an alpha blocker which helps to relax the prostate smooth muscle to allow improved urinary flow. Common alpha blocker medications include Hytrin, Cardura, Flomax, Rapaflo and Uroxatrol. The second class of medication is called a 5-alpha-reductase inhibitor, which works by shrinking the prostate. Common medications of this type include Finasteride (Proscar) and Dutasteride (Avodart). If these medications are effective at relieving urinary symptoms, you will need to take these medications daily for continued effectiveness.
Surgery for BPH
If oral medications are ineffective or if the patient desires not to take medications, Dr. Ebrahimi believes that surgical reduction in size of the prostate could be the next choice. Dr. Ebrahimi, who is a fellowship trained urologist in robotic, laparoscopic and minimally invasive urologic surgery, offers various methods of treatment for BPH (benign prostatic hyperplasia). In fact, these multiple means of treating BPH (benign prostatic hyperplasia), especially minimally invasive surgical procedures that have less side effects, allow for personalization of BPH (benign prostatic hyperplasia) treatments for patients and ultimately empower the patient with more choices. These procedures include: TURP (transurethral resection of the prostate), Green light laser photo-vaporization of the prostate, TUMT (transurethral microwave therapy of the prostate), and da Vinci Robot Assisted Suprapubic Prostatectomy and are described more fully on the procedures section of StarUrology.com. Please click on the highlighted links to read about these procedures or call Dr. Ebrahimi’s office for an appointment or if you have further questions.