Benign prostatic hyperplasia (BPH) refers to a non-cancerous growth of the prostate gland that happens to most men as they grow older. This enlargement may lead to a variety of urinary symptoms, such as a weak urinary stream, difficulty starting the stream, frequent urination, urgent urination, arising from sleep to urinate and others. In more serious situations, BPH can cause a complete inability to urinate, infection, bladder stones or failure of the bladder or kidneys to function properly. It is very important for all men over the age of 50 to have their prostate checked at least once per year to make sure there are no signs of cancer. Once it has been established that cancer is not present, then a variety of approaches may be used to try to relieve the symptoms associated with an enlarged prostate.
In most cases, the primary goal of treatment of BPH is improvement in the quality of life of the patient. Therefore, it is most commonly up to the patient how they would like to proceed when it comes to treatment. For many men, no treatment of BPH may be appropriate. Although some men may have urinary symptoms due to an enlarged prostate, unless it is bothering them sufficiently that treatment is desired, simply altering fluid intake and other behavioral changes may be all that is needed. For those men with more severe symptoms, a variety of medications are available to treat an enlarged prostate. In addition, several natural remedies, such as saw palmetto, may be tried once it is clear that there are no signs of cancer, infection and so forth. At the University of Chicago, we have conducted several widely recognized studies using saw palmetto and other natural remedies for BPH. These have generally demonstrated mild to moderate improvement in symptoms without any apparent side effects.
For those patients who do not respond to medication, several procedures are available to treat an enlarged prostate. These include the traditional transurethral resection of the prostate (TURP), laser procedures, microwave procedures, as well as several others. At the University of Chicago we continue to explore new and better ways to treat men with BPH with an emphasis on tailoring therapy to the individual patient's needs and desires.
Greenlight Laser for Benign Prostatic Hyperplasia (BPH)
The treatment for men with enlarged prostates and difficulty urinating has evolved greatly during the past 5-10 years. One of the most exciting developments has been photovaporization of the prostate (PVP) using the Greenlight laser. This technique allows for the direct removal of prostate tissue similar to what occurs during the more traditional transurethral resection of the prostate (TURP). However, since the tissue is vaporized using the laser, bleeding is minimal allowing most patients to go home from the hospital on the same day as the procedure often without the need for a urinary catheter. This technique is a distinct advantage compared with microwave therapy (TUMT) or transurethral needle ablation (TUNA) which require weeks to months for the prostate to decrease in size following treatment. The results with the Greenlight laser simulate those that can be achieved with a TURP, which has been the gold standard for treating men with enlarged prostates for decades. However, the morbidity, side effects and recovery period are far superior to those seen with TURP. The vast majority of men who have had the Greenlight procedure at the University of Chicago have been overwhelmingly satisfied with the results and the most common comment is that they wish they had not waited so long to have it done.