When all other BPH treatments fail there’s this - Cape Cod Healthcare

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Published on January 29, 2018

When all other BPH treatments fail there’s thisWhen all other BPH treatments fail there’s this

Approximately 50 percent of all men between 51 and 60 years old have an enlarged prostate, or Benign Prostatic Hyperplasia (BPH), according to the Urology Care Foundation. As men age, the risk is higher and by the time they reach 80 years, about 90 percent will have it.

The prostate is part of the male reproductive system. A small walnut-size gland that weighs about one ounce, it sits below the bladder and in front the rectum. As the gland enlarges, it can compress the urethra, which is the tube that carries the urine out from your bladder. The constriction can restrict urine flow.

“If you look inside the urethra, you’ll see the prostate tissue collapsing down like a clog in a drain,” said John J. Homa, DO, FACOS, a urologist at Cape Cod Hospital. Think of your bladder as the sink, the urethra is the pipe and the prostate is the clog.”

But, there are treatment options to alleviate the condition after other options fail, he said. One of the minimally invasive treatments is GreenLight Laser Therapy , also known as photoselective vaporization (PVP). The surgery is done under general anesthesia, and a fiber is passed through a scope that has been inserted through the tip of the penis into the urethra. It delivers high-powered green laser light “that vaporizes the prostate tissue,” said Dr. Homa.

Once the tissue has been removed, it allows urine to flow freely and reduces the symptoms related to BPH. Dr. Homa performs about 56 of these procedures annually.

“The greatest advantage is much less bleeding during this procedure, which translates into the overwhelming majority of men going home the same day of surgery,” said Dr. Homa.

Most patients will need a catheter to drain the urine, typically for one to three days. “The duration of the catheter depends on the severity of the symptoms before surgery and the size of the prostate,” Dr. Homa said.

Patients can return to regular activities in two to three days.

Another advantage of this procedure is the option to do it again if symptoms return.

“Most times the lining of the urethra heals smoothly and remains open but can be repeated if necessary,” said Dr. Homa. We like to get at least five good years or more of improvement of symptoms.”

The GreenLight Laser Therapy is one of the last options for treatment of BPH.

“There are men with enlarged prostates who have mild urinary symptoms that don’t need any therapy,” said Dr. Homa. If patients have worsening symptoms, there are medication options that relax and shrink the prostate. They can use medication for the long-term to avoid surgery. It’s the patients whose symptoms are not relieved with the medications or have ongoing worsening symptoms that benefit from moving on to surgery.”

According to the Urology Care Foundation, symptoms of BPH are:

  • The need to urinate often every one to two hours, especially at night
  • A full feeling in the bladder even after urinating
  • A feeling of urgency, can’t wait
  • Weak urine flow
  • Dribbling of urine
  • Need to stop and start urinating
  • Trouble starting to urinate
  • Need to push or strain to urinate

The Urology Care Foundation recommends you be seen by your physician if you experience any of these symptoms. In severe cases, if you cannot urinate, it is considered an emergency and you need to seek medical attention, immediately.