Benign Prostatic Hyperplasia (BPH/Enlarged Prostate)
The prostate is a walnut-sized organ located immediately below the bladder. The urethra, which carries urine from the bladder and out of the body, travels through the middle of the prostate. As men age, the prostate begins to expand. This is known as benign prostatic hyperplasia (BPH). As the prostate grows, it can lead to obstruction of urine passage.
Lower Urinary Tract Symptoms (LUTS) – When the prostate causes obstruction of urine flow, it can lead to the development of LUTS. These can include
- Hesitancy – Waiting for longer before urine starts to pass
- Intermittency – Stopping and starting throughout urination
- Weak urinary stream
- Sensation of incomplete bladder emptying
- Frequency of urination
- Urgency of urination
- Waking two or more times to urinate
Urinary Retention – Patients with severe urinary obstruction can develop urinary retention, in which the bladder is unable to adequately empty.
If urinary retention happens suddenly, it is often accompanied by severe lower abdominal pain coupled with an inability to urinate. This is almost always an emergency, and should be evaluated by a medical professional right away.
Urinary retention can also happen slowly, over time. When this occurs, there are often only mildly bothersome urinary symptoms, such as frequency of urination, urgency of urination, or incontinence. If left untreated for too long, urinary retention can lead to urinary tract infections, kidney failure, or irreversible bladder failure requiring lifelong catheter dependence
Transrectal Ultrasound of the Prostate (TRUS) is a procedure performed in the office to evaluate the prostate. A small lubricated ultrasound probe is placed into the rectum. The probe uses soundwaves to create an image of the prostate, which lies immediately in front of the rectum. The procedure can be performed with nitrous oxide, to help with patient anxiety and discomfort.
Cystoscopy is an office-based procedure used to evaluate the architecture of the prostate. A soft flexible telescope is passed down the urethra and into the prostate to confirm an obstructive architecture and plan for surgical treatment. The procedure can be performed with nitrous oxide, to help with patient anxiety and discomfort.
Rezum is an office-based procedure that is used in the treatment of BPH. The procedure is almost always done with the use of nitrous oxide, to help with patient anxiety and discomfort. Your urologist will pass a telescope down the urethra and into the prostate. Steam is injected into the prostate to kill the tissue causing urinary obstruction. At the end of the procedure, a foley catheter is placed to allow the prostate to heal. Depending the individual circumstance, this catheter will be removed anywhere from 3-30 days after the procedure.
Following Rezum, 90% of men are able to avoid further treatment for BPH for at least 5 years after the procedure.
Urolift is an office-based procedure used in the treatment of BPH. The procedure is almost always done with the use of nitrous oxide, to help with patient anxiety and discomfort. Your urologist will pass a telescope down the urethra and into the prostate. Alloy clips are placed to pin back obstructing prostate tissue. One of the benefits of Urolift is that a catheter is generally not required after the procedure.
Following Urolift, 70% of men are able to avoid further prostate surgery for at least 5 years.
Greenlight Photoselective Vaporization of the Prostate (PVP) is a procedure used in the treatment of BPH. It is performed at either an ambulatory surgery center or hospital. The procedure is performed with either spinal or general anesthesia. Your urologist will pass a telescope down the urethra and into the prostate. A laser is then used to vaporize any obstructing prostate tissue. At the end of the procedure, a foley catheter Is placed to allow the prostate to heal. Patients are usually able to go home the same day after a Greenlight PVP. The foley catheter is removed 1-7 days after the procedure, usually in the office.
Following Greenlight PVP, 93% of men are able to avoid further prostate surgery for at least 5 years.
Clarksville Urology is the only Greenlight PVP Center of Excellence in Middle Tennessee
Transurethral Resection of the Prostate (TURP) is a hospital-based procedure used in the treatment of BPH. The procedure is performed with either spinal or general anesthesia. Your urologist will pass a telescope down the urethra and into the prostate. An electrified loop is used to shave out the obstructing prostate tissue. At the end of the procedure, a foley catheter is placed to allow the prostate to heal. Some patients are able to go home the same day. The remainder usually stay in the hospital one night. The foley catheter is removed 1-7 days after the procedure, usually in the office.
Following TURP, greater than 95% of men are able to avoid further prostate surgery for 10 years.
Simple Prostatectomy is a procedure performed for patients extremely large prostates. Prostate tissue causing blockage of urine flow from the bladder is removed. The procedure is performed under general anesthesia in a hospital and is often performed using robotic surgery. At the end of the procedure, a foley catheter is placed to allow the prostate to heal. Most patients are able to go home within 1-2 days after surgery. The foley catheter is removed 2 weeks after the procedure, usually in the office.
