Dr. Bogaard of Good Samaritan Hospital talks about the enlarged Prostate (BPH) and the minimally invasive treatment options available for men.
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BPH stands for Benign Prostatic Hypertrophy. It's a fancy medical term that simply means that the prostate enlarges and it causes bladder obstruction. The symptoms of BPH can typically be divided into two groups. One is the obstructive element resulting from the encroachment of the prostatic urethra, making it difficult for the patient to empty his bladder. These symptoms would be manifested with straining to urinate, diminished flow strength, that sort of thing. The other class of symptoms are referred to as irritative symptoms, and they are the result of the bladder's attempt to evacuate itself against the higher outlet obstruction. These symptoms are basically those of frequency, urgency, and oftentimes having to get up at night. Historically, the treatment for BPH has been either medical or surgical. The medical treatment typically involves one or two different drugs that can be used simultaneously. One actually reduces the smooth muscle in the prostate and allows for the channel to enlarge and it becomes easier for the patient to urinate. The other group of drugs actually shrinks the prostate. So they can work in concert and can be used simultaneously. For those patients who don't wish to use drugs, or who have failed drug therapy, surgery is offered. Surgery historically has been a transurethral resection of the prostate, in most cases. This uses an electrical source for actually cutting out the tissue through the urethral channel. This has been associated with about a 20% significant hemorrhage rate, requiring the use of blood transfusions. In more recent years, a number of other surgical options have been developed, including the KTP Laser, which is known to the lay population as photoselective vaporization of the prostate. This technology allows for the removal of the prostate tissue and opening up the channel with the use of laser or heat therapy, which vaporizes the tissue. This technology is not associated with significant bleeding, and transfusions are almost unheard of in this particular treatment. We have at Good Samaritan Hospital done over 500 cases in the last six years, and we have not had any significant bleeding, nor have we ever had to transfuse a patient with this particular treatment. A laser therapy has advantages over traditional surgical therapy, in the sense that it can be done as an outpatient. There is typically no bleeding associated with it. Transfusions are almost unheard of. The incidence of a erectile dysfunction also is extremely uncommon. So in all, it has several advantages, it's much safer, much lower morbidity associated with the procedure. It typically takes about an hour or less, depending upon the size of the prostate. The patient is advised that two week period of convalescence would be required, in the sense that he would be advised against heavy lifting, otherwise he would return to his normal activities almost from the first day after the surgery. I want to really emphasize the fact that it is a procedure which is, on the one hand effective, and on the other hand is fairly complication free. For more information, call 1-800-GS-Cares. Good health to you!