Ralph A. Highshaw, M.D.

Benign Prostatic Hyperplasia othewise known as BPH or an enlarged prostate is common to many men. Fifty-percent of men ages 5o and above may have symptoms. The chance of being symptomatic occurs in a higher percentage each decade after age 50.

The symptoms include frequency, urgency, nocturia ( getting up at night to urinate), incomplete emptying, hesistancy, or at worst urinary retention. treatment is recommended if your life is adversely affected by any one or more of these symptoms.

The prostate is a gland found in the pelvis and between one’s bladder, which collects the urine and empties it from the body, and the penis. More accurately, the prostatic urethra is part of the tube running through the prostate which runs out of the penis and completes the emptying of urine. Prostate cancer has not been proven to be related to BPH, although both can occur together in the prostate.

BPH is a clinical diagnosis based on a digital rectal exam and symptoms. Other studies can aid in determining it’s significance or validating the findings. These studies include a post-void residual, which tells one how much urine is left in the bladder after urination. This is a significant finding, which can also be determined with the use of a bladder ultrasound. The reason for the symptoms is due to urinary obstruction from the prostate gland expanding and closing off the prostatic urethra (the tube running through the prostate and draining the bladder).

Treatment is recommended if a person’s quality of life is affected negatively by the symptoms mentioned above. Conservative or medical treatment is usually tried first. These include medicines that increase the flow of urine by opening the channel for urine flow. Other medications include prostate shrinking medicines, which have some affect on relieving symptoms, but require use of 4 to 6 months. If medical treatments fail,then surgical treatments are used. The traditional surgical management has been the TURP (transurethral resection of the prostate). This treatment is minimally invasive and usually leads to a 23 hour stay overnight in the hospital. Another treatment includes laser vaporization of the prostate. The advantage of the laser is less bleeding and the patient can go home the same day. Other treatments include the transurethral incision of the prostate, transurethral microwave therapy of the prostate, electrovaporization of the prostate, and for those with a very large gland, a simple prostatectomy.

For more information concerning BPH contact Dr. Highshaw at (951) 509-9000.

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