BPH Treatment in Los Angeles

BPH Treatment in Los Angeles

• Frequent need to pee
• Urgency (sudden, overwhelming need to urinate)
• Peeing more often at night (nocturia)
• Difficulty starting to pee
• Weak urine stream, or a stream that stops and starts
• Dribbling at the end of urination
• Not being able to fully empty bladder
• Feeling like you still have to pee after peeing

• Urinary tract infection (UTI)
• Not being able to pee
• Blood in the urine

• Medical history – Your physician will ask you a series of questions about your experiences, symptoms, and medical history.
• Digital rectal exam – Your physician will briefly insert a finger into your rectum to see if your prostate is enlarged.
• Urine test – Used to rule out other urologic conditions that can cause the same symptoms as BPH.
• Blood test – Used to rule out kidney problems that can cause the same symptoms as BPH.
• Prostate-specific antigen (PSA) blood test – PSA is a protein that is made in the prostate. PSA levels increase in the blood when the prostate becomes enlarged, but heightened levels may also indicate other conditions.
• Urinary flow test – You pee into a container that is attached to a machine that measures how strong your urine flow is and how much urine you pass.
• Postvoid residual volume test – Ultrasound imaging or a catheter device are used to measure how much urine is left in the bladder after you pee.
• 24-hour voiding diary – You may be asked to keep a diary of how often you pee.
• Transrectal ultrasound – A special ultrasound probe is inserted into the rectum to take images of the prostate.
• Prostate biopsy – A sample of prostate tissue is taken through the rectum to rule out prostate cancer.
• Urodynamic and pressure flow studies – A catheter is inserted into the bladder via the urethra to measure bladder pressure.
• Cystoscopy – Allows your physician to visualize inside the urethra and the bladder.

BPH treatment focuses on symptom relief. Many BPH treatment options are available, ranging from oral medications to minimally invasive procedures and invasive surgeries. The ideal treatment for you will, in part, be determined by your prostate and bladder anatomy, your age, your medical history, and your treatment preferences.

We provide a brief list of medications and procedural treatment options here as an introduction for our readers, but we strongly encourage you to research your options thoroughly and to advocate for the treatment that you feel is most appropriate for you.

BPH treatment medicine is often prescribed as a first-line therapy for individuals with BPH. You may be prescribed alpha blockers, 5-alpha reductase inhibitors (5ARIs), and/or tadalafil. We briefly describe the most common BPH medications here to help make readers aware of their options, but we do not cover the full list of side effects or potential complications associated with these medications. Be sure to consult your physician and review drug labels for any medication that you start.

• Alpha blockers work by relaxing the smooth muscle of the bladder neck and the prostate, making it easier to pee. Common alpha blocker drugs include alfuzosin (Uroxatral), doxazosin (Cardura), tamsulosin (Flomax), silodosin (Rapaflo), and terazosin.
• 5ARIs shrink the prostate by inhibiting the hormone changes that cause the prostate to grow. Common 5ARIs include finasteride (Proscar) and dutasteride (Avodart). Alpha blockers and 5-alpha reductase inhibitors may be prescribed simultaneously if neither is effective enough on their own.
• Tadalafil (Cialis) is an erectile dysfunction medication that may also be prescribed to treat prostate enlargement.

If you’re still struggling to find relief after trying medications, or if you prefer not to take medications, then a procedure may be the best option for you to find relief from BPH. Interventional care is also recommended if you aren’t able to pee, have kidney problems, or repeatedly deal with bladder stones, blood in your urine, or UTIs.

Fortunately for men with BPH, there are numerous procedural options that can effectively treat BPH symptoms – so many, in fact, that you may find it difficult to identify which BPH treatment option is most suitable for your needs.

An enlarged prostate can be treated through ablative or resective approaches, which destroy excess prostate tissue to relieve pressure on the bladder and the urethra. BPH symptoms can also be treated by ‘lifting’ the enlarged prostate off of the bladder and the urethra, making it easier to pass urine. Finally, the enlarged prostate can also be made to shrink back to a reasonable size by cutting off its dominant blood supply. The procedures that are deployed to accomplish these outcomes vary greatly in approach, mechanism of action, technology, and patient candidacy.

• Prostatic Artery Embolization – Prostatic artery embolization works by embolizing (blocking) the blood vessels that supply the prostate. This is accomplished by threading a catheter to the prostate artery through a tiny puncture in your arm or in your leg using real-time imaging. Once in position, microscopic beads are injected through the catheter into the prostate artery, blocking blood flow to the prostate. Following the procedure, the prostate shrinks, relieving BPH symptoms.
• Water Vapor Ablation (Rezum) – Steam is injected into the prostate through a device that is inserted through the urethra. Water vapor ablation destroys and removes overgrown prostate tissue, relieving pressure on the urethra and making it easier to pass urine.
• Laser Ablation – A high-energy laser destroys or removes overgrown prostate tissue.
• Microwave Ablation – Microwave energy is delivered via catheter to destroy the inner portion of the prostate gland.
• Aquablation – Tiny, powerful jets of water are applied through a device that is inserted via the urethra. Aquablation removes extra prostate tissue.
• Prostate Lift (Urolift) – Small devices are implanted to compress the sides of the prostate, improving urine flow.
• Transuretheral Resection of the Prostate (TURP) – A resectoscope is used to remove all but the outer part of the prostate.
• Transurethral Incision of the Prostate (TUIP) – A resectoscope is used to make one or two small cuts in the prostate gland, making it easier for urine to pass through the urethra.
• Prostatectomy – Incisions are made in the lower stomach area to access the prostate and surgically remove prostate tissue.

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