Enlarged Prostate Archives | St Pete Urology

How the HoLEP Procedure Offers Lasting Relief from Enlarged Prostate (BPH)

St Pete Urology — Thu, 25 Sep 2025 04:23:08 +0000

3 Key Takeaways:

HoLEP offers superior long-term outcomes with less than 1% reoperation rates at 5-10 years, outperforming traditional TURP and other laser procedures while treating prostates of any size.
Modern BPH treatments range from medications to minimally invasive office procedures like Rezum and UroLift, giving men more personalized options based on prostate size, symptom severity, and lifestyle priorities.
Early consultation with experienced urologists improves outcomes by preventing complications like bladder stones, infections, and kidney damage while preserving quality of life through tailored treatment plans.

HoLEP (Holmium Laser Enucleation of the Prostate) represents a game-changing advancement for men struggling with benign prostatic hyperplasia (BPH). This minimally invasive procedure offers lasting relief from urinary symptoms with faster recovery times and superior outcomes compared to traditional surgery. If you’re one of the millions of men experiencing frequent nighttime bathroom trips, weak urine flow, or difficulty emptying your bladder, understanding modern BPH treatments can transform your quality of life.

Understanding Benign Prostatic Hyperplasia (BPH)

BPH affects approximately 50% of men by age 60 and nearly 90% by age 85. This non-cancerous enlargement of the prostate gland occurs when the transition zone surrounding the urethra expands, creating pressure that restricts urine flow. As the prostate grows from walnut-sized to potentially tennis ball-sized, it squeezes the urethra like a clamp on a garden hose.

Common BPH symptoms include weak or interrupted urine stream, frequent urination (especially at night), difficulty starting urination, inability to completely empty the bladder, and sudden urinary urgency. These symptoms arise from both physical narrowing of the urethra and increased smooth muscle tension in the prostate.

Left untreated, severe BPH can lead to bladder stones, urinary tract infections, kidney damage from urine backflow, and complete urinary retention requiring emergency catheterization. The International Prostate Symptom Score (IPSS) helps physicians assess symptom severity on a scale from 0 to 35, with scores above 20 indicating severe symptoms requiring intervention.

What Makes HoLEP the Gold Standard Treatment

HoLEP has emerged as the gold standard for surgical BPH management in the 21st century. This procedure uses a high-powered holmium laser to precisely remove enlarged prostate tissue blocking the urethra. Think of it like coring an apple—the laser separates the obstructive tissue from the outer prostate capsule (the “peel”), leaving the peripheral zone intact while clearing the urinary pathway.

The procedure works by inserting a resectoscope through the urethra under general or spinal anesthesia. A laser fiber passed through this instrument precisely cuts and enucleates the enlarged adenoma, pushing the separated tissue into the bladder. A morcellator then suctions and pulverizes these fragments for removal, ensuring complete clearance of obstructive tissue.

HoLEP excels for several reasons. Unlike traditional TURP (transurethral resection of the prostate), HoLEP is size-independent—surgeons have successfully treated prostates as large as 800 grams. The procedure typically removes 50-60% of total prostate volume, regardless of initial size. Studies show that HoLEP outcomes, catheterization time, and hospital stays remain consistent whether treating a 40-gram or 200-gram prostate.

Clinical data demonstrates superior long-term durability. HoLEP patients enjoy greater improvements in urinary flow rates, better symptom scores, and remarkably low reoperation rates of less than 1% at 5-10 years. Compare this to TURP’s 7.4% reoperation rate and GreenLight laser’s 5.6% rate, and HoLEP’s advantage becomes clear.

Comparing Modern BPH Treatment Options

Medication Management

For mild to moderate BPH symptoms, medication often serves as the first-line treatment. Alpha-blockers like tamsulosin relax prostate smooth muscle to improve urine flow within days. 5-alpha reductase inhibitors (5-ARIs) such as finasteride shrink the prostate over 3-6 months by blocking testosterone conversion to DHT. Combination therapy works best for men with prostates larger than 30 grams or PSA levels above 1.5 ng/mL.

Medications carry trade-offs. Alpha-blockers may cause dizziness, fatigue, or retrograde ejaculation. 5-ARIs can lead to sexual side effects in 3-4% of users and require 6-12 months for full effectiveness. Phosphodiesterase-5 inhibitors like tadalafil help some patients with both BPH and erectile dysfunction. While effective for symptom management, medications don’t physically remove tissue or provide permanent solutions.

Minimally Invasive Office Procedures

Rezum water vapor therapy delivers targeted steam to destroy excess prostate cells. Performed in-office under local anesthesia, Rezum works well for prostates under 80ml with minimal recovery time. However, symptom improvement takes 2-4 weeks as dead tissue gradually absorbs.

Prostatic urethral lift (UroLift) uses permanent implants to mechanically hold prostate lobes apart, widening the urethra without tissue removal. This preserves sexual function but works best for smaller prostates without significant middle lobe enlargement. The procedure takes 30-45 minutes with same-day discharge.

Laser Procedures

GreenLight laser therapy vaporizes prostate tissue using photoselective vaporization. It offers excellent hemostasis (minimal bleeding) and quick recovery, making it ideal for patients on blood thinners. Recent advances allow treatment of larger prostates, though durability doesn’t match HoLEP’s track record.

Thulium laser enucleation (ThuLEP) works similarly to HoLEP but uses different laser wavelength. Both achieve comparable outcomes, though HoLEP has more extensive long-term data supporting its use.

Traditional Surgery

TURP remains widely performed but increasingly outdated. An electrical loop shaves away prostate tissue like carving a channel through the gland. While effective, TURP carries higher bleeding risk, longer catheterization (typically 2-3 days), and that 7.4% reoperation rate within 5-10 years.

Open prostatectomy through abdominal incision is now reserved for extremely large prostates (over 150 grams) when HoLEP isn’t available. Recovery takes 4-6 weeks with higher complication risks.

HoLEP Procedure: What to Expect

Pre-Operative Preparation

Before HoLEP, patients undergo comprehensive evaluation including blood work, urinalysis, PSA testing, and potentially imaging studies like transrectal ultrasound or MRI to measure prostate volume. An EKG and chest X-ray assess overall fitness for anesthesia.

Patients typically stop blood-thinning medications 5-7 days before surgery under physician guidance. Antibiotics may be prescribed to prevent infection. Fasting for 8 hours before the procedure reduces anesthesia complications.

The Procedure Day

HoLEP takes 60-120 minutes depending on prostate size. Under general or spinal anesthesia, you feel nothing during surgery. The urologist works entirely through the urethra—no external incisions means no visible scarring.

Most patients stay overnight for monitoring, though some centers now offer same-day discharge for straightforward cases. A urinary catheter drains the bladder for 1-3 days post-procedure, occasionally just overnight in uncomplicated cases.

Recovery and Results

Initial post-operative symptoms include blood in urine (intermittent for several weeks), temporary urinary frequency or urgency, and mild burning during urination. These typically resolve within 2-4 weeks as healing progresses.

Most men resume light activities within a few days and return to normal routines within 1-2 weeks. Avoid heavy lifting (over 10 pounds) and strenuous exercise for 4 weeks. Sexual activity can usually resume after 4-6 weeks once cleared by your urologist.

Urinary improvements often appear immediately, with full benefits realized within 3 months. Studies show patients experience dramatic increases in peak urinary flow rates and substantial decreases in symptom scores that persist for years.

When to Consider HoLEP vs. Other Treatments

HoLEP works best for men with moderate to severe BPH symptoms affecting quality of life, particularly those with larger prostates (over 80ml) where other procedures have limitations. It’s ideal if you want definitive, long-lasting relief and can tolerate 1-2 weeks recovery.

Consider office procedures like Rezum or UroLift for mild to moderate symptoms with smaller prostates, especially if quick recovery and preserved sexual function are priorities. These require minimal downtime but may need retreatment sooner.

Medications suit men with mild symptoms willing to take daily pills long-term, though they manage rather than cure the underlying problem.

Discuss with your urologist factors including prostate size, symptom severity, overall health, bleeding risk (especially if taking blood thinners), and personal priorities regarding recovery time versus treatment durability.

Expert Care at St Pete Urology

St Pete Urology’s board-certified urologists—Dr. Nicholas Laryngakis, Dr. Reid Graves, Dr. Adam Oppenheim, and Dr. Ankur Shah—bring extensive expertise in minimally invasive urological procedures, including state-of-the-art BPH treatments.

Dr. Laryngakis and Dr. Shah specialize in advanced robotic and laser procedures, offering comprehensive solutions from medication management to cutting-edge surgical interventions. Dr. Graves focuses on men’s health and incontinence management, including GreenLight laser certification. Dr. Oppenheim provides specialized training in urologic prosthetics and comprehensive BPH care.

Our practice combines clinical excellence with compassionate, patient-centered care. We understand that urological conditions carry social discomfort, so we emphasize sensitivity and discretion while partnering with you to find the optimal treatment for your unique situation.

Conclusion

Modern BPH treatment has evolved dramatically from the days of prolonged catheterization and lengthy recoveries. HoLEP represents the pinnacle of this advancement—offering definitive, durable relief with minimal invasiveness and rapid recovery for men of all prostate sizes.

Whether you’re just beginning to experience symptoms or have lived with BPH for years, effective treatments exist. The key is early consultation with experienced urologists who can tailor therapy to your specific anatomy, symptoms, and lifestyle.

Don’t let an enlarged prostate control your life. From interrupted sleep to avoiding social situations, BPH significantly impacts quality of life. Modern treatments offer genuine solutions.

Ready to discuss your BPH treatment options? Contact St Pete Urology at (727) 478-1172 to schedule a consultation. Our conveniently located office at 830 Central Ave, Suite 100, St. Petersburg, FL 33701 serves the greater Tampa Bay area with comprehensive urological care.

References:

Gilling, P. J., Aho, T. F., Frampton, C. M., King, C. J., & Fraundorfer, M. R. (2008). Holmium laser enucleation of the prostate: Results at 6 years. European Urology, 53(4), 744-749. https://doi.org/10.1016/j.eururo.2007.04.052
American Urological Association. (2025). Benign prostatic hyperplasia (BPH) guideline. https://www.auanet.org/guidelines-and-quality/guidelines/benign-prostatic-hyperplasia-(bph)-guideline
Cleveland Clinic. (2025). Holmium laser enucleation of the prostate (HoLEP). https://my.clevelandclinic.org/health/treatments/17917-holmium-laser-enucleation-of-the-prostate-holep
National Institute of Diabetes and Digestive and Kidney Diseases. (2025). Enlarged prostate (benign prostatic hyperplasia). https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/enlarged-prostate-benign-prostatic-hyperplasia

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How Effective Are Non-Surgical Treatments for BPH?

St Pete Urology — Fri, 16 Feb 2024 03:38:39 +0000

3 Key Takeaways:

Non-surgical treatments for BPH, such as medications, minimally invasive procedures, and other alternatives like prostatic artery embolization and herbal supplements, can be effective in managing symptoms and improving quality of life.
The effectiveness of these treatments has been evaluated through rigorous clinical studies and research trials, with criteria such as improvement in urinary symptoms, increase in urinary flow rate, and reduction in post-void residual urine volume.
While non-surgical treatments offer promising results, limitations such as patient selection criteria, individual variability in responses, and long-term efficacy and cost-effectiveness considerations should be taken into account.

Let’s talk about benign prostatic hyperplasia (BPH), or enlarged prostate, an inconvenience that has affected too many lives. This common urological condition often requires dedicated management, leading to the question we are addressing: how effective are non-surgical treatments for BPH? It’s a pertinent question that needs an informed answer, and that is precisely what we aim to provide.

Overview of Non-Surgical Treatments for BPH

When it comes to non-surgical treatments for BPH, the options are piquantly assorted. First, there are medications. Alpha blockers and 5-alpha reductase inhibitors help to relax the prostate and reduce its size, often used in combination for greater effect.

Next, we have minimally invasive procedures. Transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), and laser therapy form this triad, presenting less invasive alternatives that offer hope without a scalpel.

Finally, other non-surgical alternatives such as prostatic artery embolization (PAE) and, surprisingly, herbal supplements find their place in the roster.

Evaluating Effectiveness of Non-Surgical Treatments

We judge the effectiveness of these treatments on a platform of rigorous clinical studies and research trials. The gold standard: randomized controlled trials (RCTs), supplemented by systematic reviews and meta-analyses.

Our assessment criteria are clear: improvement in urinary symptoms, enhancement of quality of life, an increase in urinary flow rate and reduction in post-void residual urine volume, and mitigated side effects and complications. We also draw comparisons with surgical interventions like TURP and laser prostatectomy.

Findings and Effectiveness of Non-Surgical Treatments

Through rigorous evaluation, we’ve found that alpha blockers and 5-alpha reductase inhibitors, when applied in combination therapy, can significantly improve symptoms. The minimally invasive procedures, too, have shown promise, with TUMT, TUNA, and laser therapy offering good outcomes. Other non-surgical alternatives like PAE and herbal supplements present variable effectiveness, though their place in treatment shouldn’t be disregarded.

Limitations and Considerations

While the effectiveness of non-surgical treatments for BPH is promising, they are not without limitations. Patient selection criteria, variability in individual responses, and questions on long-term efficacy, durability, and cost-effectiveness should all be considered.

Conclusion

The journey of understanding these treatments is a complex one, revealing the hopeful promise of non-surgical interventions for managing BPH. These options offer relief to many men who suffer from an enlarged prostate, but it’s important to remember that the effectiveness varies among individuals.

As we look into the future of urology, we remain optimistic about advancements in non-surgical options for BPH treatment. And it is in this hope-filled landscape that we, at St Pete Urology, operate. Nestled in the heart of St. Petersburg, FL, our team of dedicated urologists have the skills, experience, and the relentless commitment to providing the best possible care for our patients. Whether you’re considering surgical or non-surgical treatments for BPH, your health and wellbeing are our priority. With St Pete Urology, you’re not just in capable hands, but compassionate ones, too.

References:

“Transurethral microwave thermotherapy (TUMT).” https://www.mayoclinic.org/tests-procedures/tumt/about/pac-20384886.
“Transurethral Needle Ablation of the Prostate (TUNA).” https://www.mercy.com/health-care-services/urology/treatments/transurethral-needle-ablation-prostate.
“Prostatic Artery Embolization (PAE).” https://www.uncmedicalcenter.org/uncmc/care-treatment/urology/prostatic-artery-embolization/.

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BPH (Enlarged Prostate): What Is It?

St Pete Urology — Fri, 27 Oct 2023 07:02:01 +0000

3 Key Takeaways:

BPH (benign prostatic hyperplasia) is a commonly occurring condition that affects nearly every man after the age of 40.
Symptoms of BPH include reduced urinary stream, nocturia (frequent nighttime urination), urinary retention, urgency, frequency, and dribbling.
Treatment options for BPH involve both surgical and pharmacological therapies, and seeking early intervention is key to maintaining overall health and quality of life.

BPH, or benign prostatic hyperplasia, is a commonly occurring condition faced by men, particularly as they advance in years. An age-related nonmalignant growth of the prostate, BPH is a condition that will affect nearly every man at some point after the age of 40. To put it in stark perspective? “9 out of 10 men over the age of 85 are diagnosed with BPH.” This prevalence underscores the importance of understanding the causes, symptoms, and treatment options associated with BPH.

What Causes BPH?

According to research, it is the shifting hormone levels with increasing age that disrupt the balance between cell proliferation and cell death, leading to the enlargement of the prostate. At the initial stages, this enlargement results in microscopic nodules that continuously grow in volume and mass. The abnormal growth predominantly occurs in the transition zone, the area surrounding the urethra.

Recognizing the Symptoms

The impact of BPH tends to manifest in disruptive lower urinary tract symptoms. As the prostate enlarges, symptoms such as reduced urinary stream, nocturia (frequent nighttime urination), urinary retention, urgency, frequency, and dribbling begin to appear. These symptoms are commonly a resultant effect of the prostate’s enlargement impeding the usual functioning of the urethra.

Addressing BPH: Treatment Options

Addressing the challenge of BPH often involves both surgical and pharmacological therapies. The choice of treatment is largely dependent on the severity and specifics of each patient’s condition. As with any medical condition, early detection and proactive management are key to maintaining one’s overall health and quality of life.

St Pete Urology: Your Local BPH Specialists

The journey towards managing and maintaining your prostate health doesn’t have to be a solitary one. Specialists in the field, such as those at St Pete Urology in St Petersburg, FL, are dedicated to helping patients navigate the complexities of conditions like BPH. With a patient-focused approach, St Pete Urology emphasizes understanding each individual’s journey and tailoring a treatment plan that addresses their unique needs.

Maintaining prostate health is a shared journey, and finding the right urologist is a critical step. In the hands of specialists like those at St Pete Urology, men suffering from symptoms of BPH can find both a compassionate ear and expert care. Remember, early intervention can help manage and control symptoms, so don’t hesitate to reach out to St Pete Urology for help managing your BPH and overall prostate health.

References:

“Do You Have a Hormone Imbalance? – WebMD.” 28 Aug. 2023, https://www.webmd.com/women/ss/slideshow-hormone-imbalance.
“Benign Prostatic Hyperplasia (BPH) Treatment & Management.” 22 Mar. 2023, https://emedicine.medscape.com/article/437359-treatment.
“The Importance of Being Proactive: Understanding Benign Prostatic ….” 25 Jun. 2021, https://www.inspirahealthnetwork.org/news/importance-being-proactive-understanding-benign-prostatic-hyperplasia.

Transcription:

BPH is an age-related nonmalignant growth of the prostate that will affect nearly every man at some point after the age of 40 years. 9 out of 10 men over the age of 85 years are diagnosed with BPH. Due to altering hormone levels with increasing age, the balance between cell proliferation and cell death is no longer maintained, which causes the prostate to enlarge.

This enlargement initially results in microscopic nodules that continuously grow in volume and mass. The abnormal growth is generally located in the transition zone, which surrounds the urethra. As a consequence, BPH often causes lower urinary tract symptoms that begin to appear as reduced urinary stream, nocturia, urinary retention, urgency, frequency, and dribbling. BPH is commonly treated with surgical and pharmacological therapies.

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Is an Enlarged Prostate Always a Sign of BPH?

St Pete Urology — Mon, 18 Sep 2023 03:19:51 +0000

Key Takeaways:

An enlarged prostate isn’t always indicative of BPH and other conditions, medications, and lifestyle factors can contribute to prostate enlargement.
Diagnosing BPH isn’t a simple tick-box exercise and a variety of tests may be used to confirm or rule it out.
If you’re facing symptoms that suggest an enlarged prostate, don’t hesitate to seek expert medical advice.

You may be familiar with the prostate – a small, walnut-sized gland playing a critical role in the male reproductive system. Primarily responsible for the production of seminal fluid, it’s an organ that is often overlooked until something goes wrong, such as the development of Benign Prostatic Hyperplasia or BPH.

What Does an Enlarged Prostate Mean?

An enlarged prostate is exactly what it sounds like: the gland has grown in size. But why? Several factors, including age and hormone levels, can contribute to this enlargement. But does an enlarged prostate automatically equate to BPH?

Unpacking BPH

BPH is a common condition characterized by an enlarged prostate, but not all instances of prostate enlargement signify its presence. BPH symptoms can involve frequent urination, difficulty starting and stopping urination, and feeling as though your bladder isn’t entirely emptied.

The Other Suspects: Beyond BPH

Prostatitis, inflammation of the prostate, or prostate cancer could also be behind your enlarged prostate. Certain medications, too, can induce prostate enlargement as a side effect. You see, diagnosing BPH isn’t a simple tick-box exercise.

The Art of Distinguishing an Enlarged Prostate from BPH

Your urologist will conduct several diagnostic tests to confirm or rule out BPH. This could include a digital rectal examination, urinalysis, or a prostate-specific antigen test. It’s through understanding these results and your symptoms that BPH can be differentiated from other conditions.

Facing BPH: Your Treatment Options

Should BPH be confirmed, a variety of treatment options are available, from lifestyle changes like reducing fluid intake before bedtime to medication. Minimally invasive procedures are often explored before surgical interventions are considered.

The Uncertainty: When an Enlarged Prostate may not Indicate BPH

If your prostate tests show enlargement, but your symptoms don’t match BPH, your urologist may delve deeper into other potential causes. This could involve further tests and evaluations to rule out serious conditions like prostate cancer.

Conclusion: Key Points and the Path Forward

An enlarged prostate isn’t always indicative of BPH, and true symptom relief depends on identifying the correct underlying issue. Other conditions, medications, and even lifestyle factors can contribute to prostate enlargement. Recognizing this is the first step towards relief.

If you’re facing symptoms that suggest an enlarged prostate, don’t hesitate to seek expert medical advice. In St Petersburg, FL, St Pete Urology offers a dedicated team of experienced urologists determined to diagnose accurately and treat effectively, ensuring your prostate health is in the right hands. So, don’t let worries about your prostate keep you up at night, reach out to St Pete Urology, and take control of your health today.

References:

St Pete Urology. (2013, March 11). What is Prostate Enlargement? St Pete Urology. https://stpeteurology.com/what-is-prostate-enlargement/
St Pete Urology. (2018, June 13). Prostate Enlargement BPH. St Pete Urology. https://stpeteurology.com/prostate-enlargement-bph/
And, D. (2023, September 18). Prostate Enlargement (Benign Prostatic Hyperplasia). National Institute of Diabetes and Digestive and Kidney Diseases; NIDDK – National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia
NHS Choices. (2023). Overview – Benign prostate enlargement. https://www.nhs.uk/conditions/prostate-enlargement/
Prostate-Specific Antigen (PSA) Test. (2022, March 11). National Cancer Institute; Cancer.gov. https://www.cancer.gov/types/prostate/psa-fact-sheet

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How to tell if your prostate is enlarged?

St Pete Urology — Mon, 05 Aug 2019 12:53:46 +0000

The prostate gland is an integral part of the male reproductive system. It secretes seminal fluid, which nourishes sperm as they grow and facilitates their transportation during ejaculation. It is located between the bladder and the rectum and surrounds the base of the urethra. Due to its location next to key parts of the urinary system, the health of the prostate gland tends to have a direct impact on the health of a man’s urinary system.

The prostate gland grows larger as a man ages. While this gradual enlargement is normal, by the time a majority of men turn 50, the prostate has reached a size where it may start to affect the normal functioning of the urinary organs near it. It is at this point that a man is said to have an enlarged prostate, or clinically speaking, benign prostate hyperplasia (BPH).

Signs and Symptoms of an Enlarged Prostate

An enlarged prostate presses, pinches or causes a blockage in the urethra. The urethra carries urine from the bladder to outside the body. The direct effects of an enlarged prostate are manifested by difficulty in the discharge of urine. These difficulties could be in the form of:

1. Frequent and sudden urges to discharge urine;

2. Difficulty starting a urine stream;

3. Weak urine stream; and

4. Dribbling urine.

If left untreated, the effects of an enlarged prostate can cause the following complications:

1. Acute Urine retention. This is a complete inability to pass urine. Medical attention must be sought immediately if this occurs;

2. Urinary tract infections;

3. Blood in the urine;

4. Pain when passing urine; and

5. Pain in the lower abdomen.

Sometimes an enlarged prostate does not produce symptoms. When this occurs in some men, it may not even be possible to diagnose the condition because it gives them no trouble at all.

The key to diagnosing and treating an enlarged prostate lies with frequent prostate monitoring by a qualified urologist. Men approaching age 50 should get tested or at least keep a watch out for any of the symptoms listed above. The good news is there are many successful treatment options for the condition. Our specialists at St Pete Urology are experienced and well qualified to help with any questions, concerns and treatment. If you think you may have an enlarged prostate, or are experiencing any problems, by all means contact us. For more information, visit the St Pete Urology website.

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Early Signs of an Enlarged Prostate

St Pete Urology — Wed, 26 Sep 2018 13:58:40 +0000

As you grow older, your prostate also grows and swells. But if it becomes very large, it can lead to a condition called BPH (benign prostatic hyperplasia), which simply means your prostate has grown too large though not cancerous. Usually called an enlarged prostate, BPH is a frequent condition in men, especially those in their 50s or older. It is primarily caused by excess DHT, an extremely powerful form of testosterone which triggers aggressive multiplication of prostate cells. Recent studies also indicate that excessive estrogen in the body plays a role in the overgrowth of the prostate.

How can you know that you have an enlarged prostate?

Located right next to the bladder, the prostate is a tiny, walnut-sized gland that’s vital for the normal functioning of the male reproductive system. It is wrapped around the urethra (the tube that takes urine away from the bladder) and significantly influences how the urethra transports both sperm and semen. As the prostate grows and swells, it puts a lot of pressure on the bladder and can obstruct urine flow through the urethra, resulting in various urinary issues.

If you have an enlarged prostate, you will:

Find it difficult to urinate.
Experience dribbling after urinating.
Feel the need to urinate frequently, often at night.

The early warning signs of BPH include:

1. Weak or slow urination

As your prostate enlarges, it puts pressure on your urethra and bladder, interrupting urine flow, resulting in either a weak flow or a prolonged stay in the bathroom. This is a very early and most common sign of BPH, and you’ve probably heard older men joke about how long they take to urinate. So when you have an enlarged prostate, urine does not exit normally and the resulting stream is quite weak.

2. Leaking of urine

Those embarrassing wet spots on your pants may just be the warning that you have an enlarged prostate. Why? Because a swollen prostate not only makes it difficult to urinate, but also makes it harder to retain urine in your bladder, resulting in urine leakage. The enlarged prostate also puts a lot of pressure both on your urethra and on your bladder and compromises your normal ability to hold urine.

3. Straining when urinating

Normal urination requires no effort. So if you find yourself groaning and suffering every time you are in the urinal, it may indicate that your prostate is clamping hard on your urethra.

4. Waking up several times at night to urinate

An enlarged prostate also puts extra pressure on the bladder, producing a sensation that the bladder is full even when it really isn’t. Thus waking up often at night to pass urine may indicate that you have BPH.

5. High PSA during a blood test

While prostate-specific antigen is produced in small quantities in men with healthy prostate glands and plays the critical role of liquefying semen by breaking down large seminal proteins, high levels of PSA may indicate that you have an enlarged prostate or prostate cancer. Make sure that you speak with a doctor if a test shows that you have high PSA in your blood.

6. Sexual dysfunction

BPH can trigger erectile dysfunction and difficulty with ejaculation by applying extreme pressure on the urethra (which transports both urine and semen) and reducing your sexual function. So if you are finding it difficult to have an erection or ejaculation, you should see your doctor for an examination to identify the problem. It may just be an enlarged prostate.

How can a urologist help?

When you experience the warning signs, you need to see your doctor to determine if you have an enlarged prostate. If an examination establishes that you have BPH, the urologist will recommend the right treatment. The most common approaches to treating BPH include:

1. Watchful waiting (active surveillance): If during assessment it is found that your symptoms are mild and not very troublesome, the urologist may recommend that you wait for a while before you commence treatment. Your symptoms will be monitored during this period to see if they are getting worse and require intervention. Your doctor will determine how frequent you need to go for checkup. The treatment can be started later if the symptoms worsen.

2. Medications: Your urologist may recommend medicines for shrinking the prostate gland or to relax the muscles around the gland in order to reduce or relieve symptoms. Make sure to speak with your doctor about possible side effects of these medicines.

3. Surgery: If medicines fail, the urologist may suggest that you undergo surgery to help improve urine flow. Different types of surgical procedures can be used, so talk to your doctor about the right option for you and about the risks involved. After surgery, regular medical checkups are very important.

4. Other treatments: To reduce the extra prostate tissue and relieve urinary problems associated with BPH, treatments such as microwaves, lasers or radio waves may be considered.

Want to know more about the health issues associated with the prostate, their diagnosis and treatment? Or you suspect that you have a prostate problem and want to speak to a knowledgeable and experienced urologist? Get all the information and help you need today by visiting the “St Pete Urology” site.

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What is the best medicine for enlarged prostate?

St Pete Urology — Wed, 11 Apr 2018 15:05:36 +0000

Treatment options for benign prostatic hyperplasia (BPH) have increased significantly in recent years. A few years ago, men suffering from BPH only had surgery as the main treatment option. This has changed as drug-makers have developed a number of drugs to offer more choices for alleviating the symptoms of an enlarged prostate. In fact, medicines now have become the most common treatment method for men with mild-to-moderate BPH. When administered, the drugs can calm bladder and prostate muscles, shrink the prostate, stop prostate growth or relieve symptoms of BPH, such as weak urine streams or the need to urinate several times per day.

Here are some drugs commonly used to treat BPH. Before using any drug, make sure to speak with your doctor to find out which medicine is appropriate for you.

1. Alpha blockers

When diagnosed with an enlarged prostate, your doctor may recommend that you take alpha blockers to ease your symptoms. These drugs relax bladder and prostate muscles and make it easier to pass urine. While they do not alter prostate size, they are effective in promoting urine flow and will prevent the need to urinate frequently or urgently. They work right away so you will not wait too long for the results.
Some alpha blockers that your doctor may suggest include:

(a) Doxazosin (Cardura)
(b) Alfuzosin (Uroxatral)
(c) Tamsulosin (Flomax)
(d) Silodosin (Rapaflo)
(e) Prazosin (Minipress)
(f) Terazosin (Hytrin)

Alpha blockers are very effective for men with both BPH and high blood pressure because they remedy both conditions. However, the drugs should not be taken by men planning to go for cataract surgery as they may cause problems during the surgery.
Side effects of alpha blockers include:

Tiredness/fatigue
Fainting
Dizziness
Lightheadedness
Headaches
Low blood pressure

Alpha blockers also can cause retrograde ejaculation, a condition in which sperm moves backward into the bladder instead of moving forward through the penis. While the condition is not harmful, it means that the fluid ejaculated may not contain sperm. Therefore, men with BPH should keep this in mind particularly if they still desire to have children.

2. 5-Alpha reductase inhibitors

In order to prevent the prostate from growing or just to shrink it, the urologist may recommend that you take a 5-alpha reductase inhibitor. Such drugs stop the body from producing one of the hormones necessary for prostate growth and enlargement. As a result, the drugs improve urine flow and relieve the symptoms of BPH. The 5-ARIs are most effective in men with very large prostates.
The two major 5-alpha reductase inhibitors recommended for BPH are:

Dutasteride (Avodart)
Finasteride (Proscar, Propecia)

Apart from shrinking or stopping the growth of the prostate and relieving BPH symptoms, the 5-ARIs have two other benefits:

They reduce the chances that BPH will result in other complications, like bladder damage.
They eliminate the need for surgery as treatment for BPH.

The full effects of 5-alpha reductase inhibitors may take up to 6 months to be realized. So you must continue taking the medicines for as long as necessary.

Side effects of 5-ARIs

5-alpha reductase inhibitors are not supposed to be used by women. In fact, pregnant women must never be exposed to the drugs as they can cause birth defects in male fetus. Other side effects of 5-ARIs include:

(a) Lower sex drive/libido
(b) Erectile dysfunction
(c) Retrograde ejaculation

Some of these side effects may improve as the body gets used to the drug.
The 5-ARI drugs also may reduce the levels of prostate-specific antigen (PSA) in the blood. PSA levels are used to screen for prostate cancer, so a drug-induced drop makes it impossible to use the PSA test. It is advisable to have the PSA test done before you start these drugs. The FDA now requires that the labels on 5-ARIs must include a warning that they may increase the risk of having aggressive (high-grade) prostate cancer.

3. Phosphodiesterase-5 inhibitors

In some cases of BPH, the urologist may recommend the use of phosphodiesterase-5 inhibitors, which are drugs that smooth the muscles of the prostate and bladder and help to relieve BPH symptoms. While there are many types of phosphodiesterase-5 inhibitors, only tadalafil (Cialis) has been approved by the FDA for treatment of BPH. Tadalafil is not prescribed as often as other drugs, but when doctors are dealing with cases in which BPH and ED occur together, then it is often a viable option.
The side effects of Tadalafil include:

(a) Headaches
(b) Muscle and back pain
(c) Stomach upset (after eating)
(d) A stuffy nose
(e) Vision problems
(f) Redness, warmth or burning on the neck, face and upper body

4. Combination therapy

When a doctor realizes that a single medication may not effectively relieve BPH symptoms, a combination of two or more drugs may be considered. The most common drug combinations for treating BPH include:

(a) Tamsulosin and Dutasteride, comes in one pill called Jalyn
(b) Doxazosin and Finasteride
(c) Alpha blocker and an antimuscarinic (a drug for treating overactive bladder)

Drug combinations are generally more effective than single drug treatments. However, the combinations also come with greater side effects than those of single drugs.

Are you or your loved one suffering from the symptoms of BPH? Would you like to receive accurate information and effective treatment for an enlarged prostate? Or do you want someone to to talk to about any other urological problem that you may have? If so, then St Pete Urology is the right place for you. For more information on the diagnosis, treatment and care for BPH, visit the “St Pete Urology site.

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Enlarged Prostate – The Apple Analogy Explained

St Pete Urology — Tue, 19 May 2015 09:16:01 +0000

As the Prostate Gland increases in size, it puts pressure to the neighboring organs specially the urethra, resulting into the constriction of the urethra passage. [Read Full Article…]

The post Enlarged Prostate – The Apple Analogy Explained appeared first on St Pete Urology.