As they get older, most men will experience benign prostatic hyperplasia (BPH), also known as an enlarged prostate. It’s an extremely common condition after age 50. The prostate gland obstructs the prostatic urethra, and as the channel becomes more and more compressed, it can cause problems, such as a weak urinary stream or irritative frequency of voiding.
Some men have very mild symptoms – difficulty urinating, incomplete emptying, and frequent urination, to name a few. Others have severe symptoms that disrupt their sleep and interfere with their quality of life. It’s important to treat BPH because it can lead to poor kidney and bladder function.
“You don’t have to have a large prostate to be symptomatic from it,” says Dr. Timothy C. Siegrist, a urologist and urologic surgeon at Middlesex Health, who offers a minimally invasive procedure called UroLift.
UroLift offers relief from BPH without the side effects that may be caused by medication, including sexual disfunction, dizziness, or fatigue. During the UroLift procedure, the surgeon puts a camera into the urethra and then places the UroLift device through the urethra. The device places tiny clips to lift and hold the prostate tissue away from the urethra. The surgeon uses a suture to pull the lobes of the prostate apart, like opening curtains. The UroLift device is then removed, leaving the clips in place.
“The downtime is minimal,” Siegrist notes. “There might be blood in the urine, and a little bit of burning for a few weeks. But there are no incisions and no hospital stay involved. I have taken care of men who have worked the next day after this procedure. Bear in mind, people are working from home, so that makes it easier. I do encourage people to take a few days off afterward.”
The procedure is generally covered by insurance. In a recent interview, Siegrist discussed the advantages of UroLift.
Q. What makes the UroLift procedure so beneficial?
A. There are a lot of procedures out there for BPH management. The most attractive aspect of this one is that our patients don’t need a catheter afterwards, or maybe just overnight. Unlike some other procedures, there are no sexual side effects. The UroLift could be done in the doctor’s office, but my preference is to do it under anesthesia. I think it’s more comfortable for the patient. UroLift is at least as good as medication, without side effects.
Q. What are the clips made of?
A. The clips are metal, which can have implications for patients who require MRI imaging. Patients are issued an implant safety card to present if MRI imaging is required after the procedure.
Q. Is any man with BPH a candidate for UroLift?
A. Not all men are candidates for the UroLift. There are some tests that are required in the office to evaluate prostate size and shape to determine a patient’s eligibility before the procedure can be done.
Q. What are some other surgeries for BPH?
A. There are many procedures available to treat BPH, some old and some new. The classic procedure is the TURP, which stands for trans urethral resection of the prostate, the “Roto Rooter” surgery. The surgeon places a camera in the urethra and scrapes away part of the prostate. It requires a hospital stay and does require a catheter. There is also a laser prostatectomy, in which we use an energy form to vaporize some of the prostate tissue. That still requires a catheter, and there is a risk some of sexual side effects. If the UroLift doesn’t work, if symptoms don’t improve as much as the patient would like, they can have the TURP later on.
Q. What about medication to treat BPH?
A. It’s not always preferable. Most men are offered medication first. If they don’t like the medications, they can always stop it. The disadvantage is the side effects: there can be sexual side effects and light headedness. A lot of men just don’t like taking meds or forget to take them. The advantage of the UroLift is that there are none of these side effects. Some men take a plant extract called Saw Palmetto, in fact they swear by it. If guys take it and they are happy with it, I encourage them to continue to do so.
Q. Is it possible to avoid an enlarged prostate altogether?
A. You are subject to your genetics. It’s not something you can prevent. There’s no screening test for BPH. If your father had it, there is a good chance you are going to have it as well.
There are behavior modifications you can make to limit your symptoms. For example, if you get up a lot at night, you can limit your fluid intake or avoid beverages like coffee or alcohol that will irritate your bladder. In men who are overweight, weight loss can improve symptoms. If someone is diabetic and poorly controlled, they urinate a lot and that can wake them up at night. Waking up at night can also be due to sleep apnea.
Q. How can men be proactive about prostate health?
A. They should try to maintain a healthy weight, limit consumptions of bladder irritants like caffeine and alcohol and consider restricting evening fluid intake to minimize the impacts of BPH.
Alix Boyle writes about health and home and real estate from her home on the Connecticut shoreline. The natural beauty of the shoreline makes her feel like she’s on vacation every day.