One of the most common reasons that men see an urologist is for the evaluation and management of urinary symptoms from enlarged prostate. Symptoms often include weak stream, hesitancy of urination, frequency and urgency of urination, getting up frequently at night to urinate, and the sensation of poor emptying of the bladder.

The cause of BPH symptoms generally is the growth of the prostate which occurs over a man’s lifetime. Usually, symptoms do not start until a man is in his 50’s, but most men will suffer from some symptoms as they age.

BPH Evaluation & Medications

The first step in the process is to rule out other things that could be causing problems such as prostate cancer, bladder cancer or urinary tract infection. The evaluation will include history, physical exam of the prostate and lab tests to include PSA and urinalysis. Initial recommendations might include a trial of medications such as Flomax (tamsulosin) or Rapaflo, noninvasive tests such as ultrasound or urine flow test. Depending on a patient’s evaluation and response to first line treatments, a cystoscopy (looking inside the bladder) may be indicated.

If medications don’t improve symptoms, there are many options that may be considered. In general, all surgical or procedural options for BPH “open” the prostate. When men have very large prostates, or certain anatomy, the best option is usually to resect or cut the prostate open (TURP or TransUrethral Resection of the Prostate). Recent improvements in this technology have allowed us to do “saline TURP” which has distinct advantages. When the prostate is modestly enlarged, with favorable anatomy, other options can be considered. In these cases, Greenlight Laser Vaporization of the Prostate (GVP) can be used as a less invasive option for BPH. Urolift may also be a good option for patients, and was recently FDA approved.

For men with moderately enlarged prostates, minimally invasive treatments are an option.

Minimally Invasive BPH Treatment Options in Bend, OR

Greenlight Laser Vaporization of the prostate is also very effective. The key to success is patient selection. The advantages of this procedure include a less invasive procedure with lower risk of bleeding, and no overnight hospital stay. The catheter usually only stays in overnight. Risks include infection, bleeding, dry orgasm, scar tissue and urgency/frequency of urination.