Benign Prostatic Hyperplasia (BPH) is a common, benign (not cancerous) condition in older men in which the prostate gland enlarges. The prostate is a walnut-sized gland that produces semen, the fluid that transports sperm. Located below the bladder and surrounding the urethra (the tube carrying urine out of the body), the growing prostate can squeeze the urethra and cause difficulty with urination.
Carolina Urology Partners in North and South Carolina is the 9th largest urology practice in the country. Our physicians provide the most sophisticated care for patients with BPH or enlarged prostate in the Carolinas.
Benign Prostatic Hyperplasia (BPH) is believed to be related to the aging process and the presence of the male hormone testosterone. More than half of men age 50 and older and 90 percent of men age 80 and older have BPH.
An enlarged prostate can cause a variety of urinary symptoms including:
- Recurring, sudden need to urinate
- Increasingly frequent urination, especially at night
- Weak or interrupted urine stream
- Difficulty starting urination
- Urine leakage
- Inability to completely empty the bladder
- Blood in the urine (hematuria)
Caffeine, alcohol, spicy or acidic foods, certain cold medications, and constipation can make symptoms worse. Left untreated, symptoms may worsen over time and can cause complications that may include inability to urinate (urinary retention), bladder or kidney damage, bladder stones or urinary infections. See your doctor for a thorough evaluation.
Our doctors and enlarged prostate specialists will take a medical history and do a physical exam. A digital rectal exam (DRE) will be performed. Your doctor may order a prostate specific antigen (PSA) test. Elevated levels of PSA can indicate BPH, prostatitis (prostate inflammation) or prostate cancer. Additional tests may include a symptom score sheet, a urine flow study, ultrasound, CT scan and a cystoscopy.
Treatment for BPH / enlarged prostate will depend on the severity of your symptoms and how much they interfere with your lifestyle. Men with minimal symptoms may only need to make lifestyle changes; those with more pronounced symptoms or complications may require medication or a procedure. Your doctor can help you determine which treatment is most appropriate for you.
The UroLift® System Treatment
What is the UroLift® System?
Treatment with the UroLift® System uses a minimally invasive approach that provides rapid relief and recovery of BPH symptoms. It is an earlier treatment option that can get men off of BPH medications and avoid major surgery. The goal of the UroLift® System treatment is to relieve symptoms so you can get back to your life and resume your daily activities. The UroLift® System treatment has demonstrated a significant improvement in quality of life for patients that is greater than reported for medications. The UroLift® System is the only BPH procedure shown not to cause new and lasting erectile or ejaculatory dysfunction, while being a safe and effective treatment of lower urinary tract symptoms due to BPH.
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How Does The UroLift® System Work?
The UroLift® System uses a revolutionary approach to treating BPH that lifts and holds the enlarged prostate tissue so it no longer blocks the urethra. It is the only available BPH treatment performed by a urologist that does not require heating, cutting, or removal of the prostate tissue. The procedure is typically performed using local anesthesia in a physician’s office or ambulatory surgery center. Patients typically return home the same day without a catheter.
UroLift® System Animation
Frequently Asked Questions
Who is a good candidate for the UroLift® System treatment?
You may be a good candidate if you are a male, 45 years of age or older, and have symptoms relating to BPH. Speak with your urologist to see if the UroLift® System treatment is right for you. If you have a known allergy to nickel, titanium or stainless steel, talk to your doctor about your allergy before getting a UroLift® System treatment.
What should I expect during the treatment? Is it painful? How long does it take?
If you and your doctor decide that the UroLift® System treatment is right for you, your doctor will provide you with more detailed information relating to the treatment. In general, the UroLift® System is a minimally invasive treatment that entails minimal downtime. Your doctor will use the UroLift® Delivery Device to deploy permanent implants to relieve obstruction caused by the enlarged prostate that is pressing on your urethra. The procedure, which usually takes about an hour, may be performed under local or general anesthesia and you may be given medication to feel comfortable during the treatment. This typically helps minimize discomfort during the procedure, though everyone’s definition for pain and discomfort varies greatly. Typically, no catheter and no overnight stay is required post-treatment.
What happens post-treatment, during the recovery period? Are meds required?
After the treatment, patients typically go home the same day without a catheter. There is minimal downtime post-treatment and many patients experience symptom relief in as early as 2 weeks. Patients may experience some urinary discomfort during the recovery period. Most common side effects are mild to moderate and include pain or burning with urination, blood in the urine, pelvic pain, urgent need to urinate and/or the inability to control the urge. Most symptoms resolved within two to four weeks after the procedure.
Does the treatment affect my sexual function?
Clinical studies have shown the UroLift® System treatment does not cause new, sustained instances of erectile or ejaculatory dysfunction. The same cannot always be said of other BPH therapies such as TURP, laser, and even medication.
Does my insurance cover the treatment?
The UroLift® System treatment is covered by Medicare and all major private insurers. Contact your insurance provider for your specific coverage information.
GreenLight™ Laser Therapy
Surgery is designed to open the prostate channel by ‘removing’ the excess tissue in the area. Traditionally, the excess tissue is removed using a small electrical loop in a procedure known as transurethral resection of the prostate or TURP. While this procedure is considered the gold standard therapy, it does require an overnight hospitalization and has a higher risk of bleeding than the other procedures mentioned.
GreenLight™ Laser prostatectomy is a safe, effective, and minimally-invasive means of treating prostate enlargement. While it does require sedation, this procedure can sometimes be done in the office setting as it does not require an overnight hospitalization. The risk of bleeding is significantly lower than with the TURP.
- Avoid caffeine, acidic drinks such as colas, tomato and orange juice, and alcohol. Cold medications containing antihistamines or pseudoephedrin, and constipation can make it more difficult to urinate.
- Limit evening beverages and urinate when you first feel the urge.
- Increase your physical activity level.
Recent studies indicate that using combinations of medications which work by different pathways may be more effective than a single medication to treat BPH.
Medications may include:
- Alpha blockers to relax the smooth muscle tissue in the bladder and prostate, increasing urinary flow
- Enzyme (5 alpha reductase) inhibitors to shrink the prostate by preventing the conversion of testosterone to dihydrotestosterone, a key ingredient in prostate enlargement
- Anti-cholinergics to reduce frequency and urgency
- Herbal products such as saw palmetto, derived from a plant in the Southeastern U.S., may reduce mild to moderate symptoms
Minimally Invasive Therapy
These procedures seek to open a passage through the prostate to allow urine to flow with less effort. Many are called “transurethral” because instruments are passed through the opening at the tip of the penis and into the urethra. Your urologist will perform the most advanced treatment using the least invasive technique appropriate to resolve your problem.
- Transurethral needle ablation (TUNA) - radiowaves heat and destroy obstructing prostate tissue
- Laser vaporization - a laser heats and vaporizes the obstructing prostate tissue
- Transurethral microwave therapy (TUMT) - microwave energy heats and destroys obstructing prostate tissue
- Transurethral incision of the prostate using electrocautery or laser
- Transurethral resection of the prostate (TURP) - obstructing tissue is removed through a cystoscope; more invasive than the preceding techniques, but urologists still use the results from the TURP as the standard by which other transurethral procedures are judged
- Prostatectomy - open procedure to remove the obstructing prostate; a less common option reserved for those with very large prostates