Office-Based Treatment for BPH
All men have a prostate gland located at the base of the bladder and the urethra runs through the middle of it (like a straw through an orange). As men grow older, the prostate will get larger and ultimately may cause obstruction of the urethra which can make it more difficult to urinate. There are several categories of medication’s that we often use to treat this condition. First line therapy involves using a quick acting medication, called an alpha blocker (e.g Flomax). There is another category of drugs that work to shrink the prostate over a period of months, called 5-alpha reductase inhibitors (e.g. finasteride). And finally, a daily dose of Tadalafil has been demonstrated to help men with urinary symptoms as well.
If medications are not effective, not well tolerated, or if a patient does not want to take a daily medication, procedures are available for treating BPH. These procedures include office-based procedures and hospital-based operations. It is important to assess each individual’s urethral and prostatic anatomy, in order to determine which of these procedures is appropriate. Your doctor will likely recommend performing a cystoscopy, which involves looking through the urethra and into the bladder. There may be a role for imaging such as an ultrasound of the prostate as well as MRI. A urodynamic study may also be necessary to assess your bladder function. Once your urologist has completed your evaluation, the available treatment options will be discussed.
We offer two office based procedures that are done through a scope inserted through the urethra. They are performed with local anesthesia, but we also offer nitrous oxide or intravenous sedation.
UroLift involves placing several permanent implants through the prostate, which will then tent open the prostatic urethra. This usually does not require any catheterization afterwards.
Rezum involves injecting steam into the prostate tissue, which will kill/ablate some of the tissue and ultimately allow the prosthetic urethra to open up to improve flow. This procedure does require a Foley catheter to be present for several days afterwards. These office based procedures are a wonderful adjunct to our armamentarium for the treatment of the BPH.
