Enlarged prostates are very common – and treatment has never been easier

This article was created in collaboration with Lumenis

You vaguely remember your father complaining about his prostate. But hey, it's not for you to worry about, is it? An enlarged prostate is something that happens to older men. Except one day peeing isn't as easy as it used to be and you go to the bathroom more often than you can count. Oh oh.

It's not a fun topic, but when you are dealing with an enlarged prostate you know you are not alone. In fact, you are in very good company. The condition known medically as benign prostatic hyperplasia (BPH) is surprisingly common. More importantly, treatment options have improved dramatically since your old man looked at it. So no more hiding in the bathroom. Let's bring that to light and break that down.

What are the symptoms of an enlarged prostate – or BPH?

The prostate is a walnut-sized gland that sits below the bladder and surrounds the urethra. Its job is to create ejaculatory fluid. Often times, as men get older, their prostate becomes larger and compresses the urethra. When this happens, urine does not flow freely from the bladder – meaning the main signs of BPH are the need to frequently urinate with a stream that drips out like a leaky faucet. You may also get up to pee several times at night. Sometimes you can make an effort to urinate. BPH is incredibly common, affecting roughly half of men over 50 and 90 percent of men over 80.

To be clear, we're not talking about cancer. An enlarged prostate is not always dangerous when it is asymptomatic. You can have an enlarged prostate without it affecting your life. However, once you start noticing symptoms, they are unlikely to resolve on their own.

"Generally, it's progressive and men will gradually get worse symptoms," said James R. Johannes, M.D., a urologist with the Lehigh Valley Health Network in Allentown, Pennsylvania. If left untreated, BPH can cause severe kidney and bladder damage and require much more extensive treatment.

How is BPH Diagnosed and Treated?

If your GP suspects that you have an enlarged prostate, they will send you to a urologist for diagnosis and treatment. The doctor will do a digital rectal exam, urinalysis, and blood tests. You may be asked to do a urine flow and volume test to see if your bladder is emptying and to track your urination over the course of a few days.

For most men, the first intervention is medicine. Some recipes relax the muscles in the bladder and prostate to help urine flow, while others can help reduce the size of the prostate. Sometimes they are prescribed together. This is why you should see a doctor immediately if you suspect something is wrong.

"Basically, the earlier the better," says Dr. John. "Sometimes we see people when the cat is out of the bag and they have serious problems."

At this point, surgery is often a good option. Fortunately, we are past the days when the procedure meant a couple of nights in the hospital and saw blood in the urine. Newer laser technologies like MOSES make prostate tissue reduction faster and less invasive. This means less bleeding and often no catheter required. Chances are you'll go home the same day – always a relief for patients.

You can hear your doctor call it the HoLEP procedure, which stands for holmium laser enucleation of the prostate. It's been around for decades. What has been drastically improved is the MOSES laser technology. The minimally invasive HoLEP surgery is carried out in three parts.

First, a resectoscope is placed in the urethra and a small camera is threaded onto the prostate so that the surgeon can visualize the blockage. Next, a laser is threaded through the resectoscope and used to remove the core from the tissue blocking the flow of urine. Finally, a cutting tool "chews" tissue until it is very small and removes it.

A laser is used throughout the procedure to reduce bleeding. The whole thing takes about 90 minutes and the chances are you'll go home the same day, which is always a relief for patients. The risk of incontinence or urine leakage is very small, as is the risk of erectile dysfunction. And if you're worried about having another operation – that the surgery didn't do enough to relieve BPH – fear not. An 18-year-old study from McGill University in Montreal found that 98.6 percent of patients did not need any further surgery.

If it's that simple, why do men avoid it?

In short, going to the urologist is agony. Talking about urination is no fun, less thinking about surgery on these parts. No wonder, it is often a woman or a partner who urges a prostate check.

But knowing that BPH is incredibly common – and that treatment is as quick and non-invasive as ever – can help.

Gary, a retired Illinois police officer, was one of those people who waited too long. When his family forced him to go to the emergency room, he was suffering from kidney failure and had to urinate through a catheter. He teamed up with Dr. Amy Krambeck, a urologist at Northwestern Medicine in Chicago who used MOSES technology. "My recovery has not been bad at all," recalls Gary. He had a week or two with bleeding, typically while urinating. "I'm fine. I feel like I'm about 18 years old again."

The other major hurdle is fear of prostate cancer.

Here is some surprising news. “Prostate cancer rarely causes urinary tract problems,” says Dr. John. The prostate has an inner, fleshy part called the transition zone and an outer area called the peripheral zone, he explains. Most BPH occurs in the transition zone, while most cancers occur in the peripheral zone.

Of course, if you have prostate-related symptoms, your doctor should do blood tests that test for markers of prostate cancer. If you are going to have a BPH procedure with MOSES or surgery to reduce the size of the prostate, your surgeon may send tissue samples for analysis. Prostate cancer can be very treatable and slow to grow, so it is best not to let major C fears prevent you from important early detection and treatment.

Back to BPH. Of course, while surgery will always remain an important, informed decision, all you know is that your options for dealing with a very common condition are much easier these days. The latest technology in prostate care can ease the process of an important treatment from start to finish. And that's no small relief.

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