Benign Prostatic Hyperplasia (prostate enlargement)

Benign prostatic hyperplasia, also called prostate gland enlargement or BPH, is a common condition as men get older. As men age, the risk of benign prostatic hyperplasia increases. Approximately 30% of men experience symptoms by age 60 and 50% of men by age 80.

Causes of BPH

The prostate gland is located beneath your bladder. The tube that transports urine from the bladder out of the urethra passes through the center of the prostate. When the prostate enlarges, it begins to block urine flow.

Most men have continued prostate growth throughout life. In many men, this continued growth enlarges the prostate enough to cause urinary symptoms or to significantly block urine flow.

The cause of prostate enlargement is unclear. However, it might be due to changes in the balance of sex hormones as men grow older.

Symptoms of BPH

An enlarged prostate gland can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder, difficulty starting the urinary strain, as well as daytime and nighttime frequency. It also can cause bladder, urinary tract, or kidney problems.

Treatment Options for BPH

Mayo Clinic Health System in La Crosse offers a wide variety of treatments for enlarged prostate. There are several effective treatments for benign prostatic hyperplasia, including medications, minimally invasive in-office therapies, and surgery.

The best treatment choice for you depends on several factors, including:

• The size of your prostate
• Your age
• Your overall health
• The amount of discomfort or bother you are experiencing

If you and your health care provider decide that in-office therapies or surgery would be the best treatment option for you, your options may include:

• Temporarily implanted nitinol device
  This procedure reshapes the tissue of the prostatic urethra and the bladder neck to create a wider channel through which urine can flow, relieving BPH symptoms. First, A nickel titanium device is inserted into the prostatic urethra in a narrow, folded configuration. Over 5–7 days, the device expands and exerts gentle pressure to remodel the prostatic urethra and opening of the bladder. After the 5–7 days, the device is removed, and patients begin to experience relief from their symptoms.
• Prostatic urethral lift (PUL)
  During the prostatic urethral lift procedure, a delivery device is placed through the obstructed urethra. Special tags are deployed and compress the sides of the prostate to hold and lift the enlarged prostate out of the way, increasing the opening of the urethra. Patients can typically return home the same day.
• Steam therapy
  Steam therapy is an in-office, minimally invasive therapy using steam to reduce the size of the prostate and alleviate symptoms. This treatment has been shown to effectively eliminate excess prostate tissue, while carrying a low risk of side effects. The procedure takes about 20 minutes, and patients go home immediately after. During the treatment, a tiny needle is inserted into the urethra and positioned within the prostate gland. In nine seconds, the needle produces a steam ball within the prostate that is about 2 centimeters wide. All the tissue the steam touches is shrunk and reabsorbed by the body within 30 to 45 days. The treatment eliminates the extra prostate tissue causing benign prostatic hyperplasia symptoms.
• Transurethral resection of the prostate (TURP)
  During the TURP procedure, a lighted scope is inserted into the urethra, and the surgeon removes all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. After TURP you might temporarily need a catheter to drain your bladder.
• Transurethral electroevaporation of the prostate (TUVP)
  During a TUVP procedure, a surgeon inserts a thin, tube-like instrument (a resectoscope) into the urethra. This instrument has a lens, light and tool that sends out an electrical current to destroy prostate tissue. Heat from the electrical current seals small blood vessels, reducing the risk of bleeding.
• Prostate enucleation
  Enucleation of the prostate removes nearly the entirety of the prostate gland without an incision. This procedure removes the most prostate tissue and can be best for a patient with an especially large prostate, the inability to stop blood thinners or in significant urinary retention. Enucleation of the prostate can be performed with both bipolar plasma energy or light energy (holmium or thulium) accomplishing the same result.