BPH: The Other Prostate Problem
Dr. David Samadi, top robotic prostatectomy SMART surgeon, knows a thing or two about prostates. In fact, he's successfully removed more than 4,000 of them from men with prostate cancer. But cancer isn't the only prostate problem out there. Benign prostatic hyperplasia (BPH), or hypertrophy, is an overgrowth of prostate cells causing an enlarged prostate gland. Dr. Samadi is also a leader in BPH surgery, performing significantly more TURP and Photoselective Vaporization of the Prostate (PVP) prostate surgeries each year than most urologists. GreenLightTM Laser PVP is one of several PVP surgeries available.
BPH is not cancerous and does not cause cancer, but the symptoms of BPH and the propensity for men to develop it are strikingly similar to prostate cancer. The incidence of BPH seems to follow right along with a man's age. An enlarged prostate occurs in about 50% of men by age 50 and 80% of men by age 80.
Like prostate cancer, the symptoms of BPH can vary from one man to the next. More often, BPH becomes enough of a lifestyle inhibitor that men pursue diagnosis. As prostate cells multiply, the prostate enlarges and restricts the urethra making urination uncomfortable and unpredictable.
Do I have BPH?
BPH symptoms start off as mild nuisances, but gradually progress as the condition worsens. Referred to as Lower Urinary Tract Symptoms (LUTS), they may include:
Gotta "go" - frequent urination, especially at night, plus a constant urge to go
Slow flow – a urine stream that's slow, weak, or stops and starts
Dribble trouble – dripping or leaking after urination
Still full – the sensation that the bladder never fully empties
Sex stop – erectile dysfunction (ED) or pain during orgasm
Obvious problem – blood in the urine or pain and burning after urination
Family history – if your dad has BPH, you may too
"Men drag their feet to the doctor," acknowledges Dr. Samadi, "but these symptoms can't be ignored. In some cases, they're a signal of prostate cancer. But men don't have to panic. BPH and prostate cancer are not one in the same. BPH is very common and surgical treatment works." BPH is confirmed through urinalysis, PSA blood testing, and rectal exam.
BPH Surgery: TURP vs. PVP
Dr. Samadi has seen prostates from every angle. His surgical background includes traditional surgery, laparoscopic surgery, and robotic prostatectomy. "With BPH, the prostate doesn't need to be removed. We essentially trim away excess prostate tissue to free the urethra and alleviate discomfort and urinary interruptions."
During TURP surgery (transurethral resection of the prostate) Dr. Samadi uses a surgical wire loop inserted through the urethra to remove small pieces of the prostate. Recovery typically involves a one-night hospital stay and a short-term catheter. Significant improvement can be seen immediately and BPH symptoms are usually fully reversed in just a few months.
PVP is a less invasive BPH prostate surgery option performed on an outpatient basis. Using a high-powered laser light, also inserted through the urethra, Dr. Samadi vaporizes excess prostate tissue constricting the urethra. Catheterization is usually shorter than with TURP, BPH symptoms improve just a day or so after the procedure, and patients return to their normal routine fairly quickly.
"There are medications available to treat BPH in its early stages," says Dr. Samadi, "but often men with severe BPH require surgery for true symptom relief. Both TURP and PVP offer highly safe and effective recovery options. I encourage men with BPH-like symptoms to seek diagnosis and explore treatment with an experienced prostate surgeon."
Dr. David Samadi is Vice Chairman, Department of Urology and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York, where he leads the nation in robotic prostate cancer surgery and BPH surgery. www.roboticoncology.com
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