BPH Treatment in Los Angeles
Finally, relief from benign prostatic hyperplasia.
Dr. Michael Lalezarian
“I was referred to Dr. Lalezarian from my orthopedic surgeon for varicose vein treatment options. From the second I walked into the office, I was at ease and felt very welcomed from Kimberly and the staff. Upon meeting the doctor, he was so kind and fully explained my options after the initial ultrasound on both legs. I decided to go with the sclerotherapy and am so happy that I did. The procedures were quick and virtually painless but the results are life changing for me. The pain suffered for so many years and countless sleepless nights are a thing of the past.”
Vickie W, March 2022
What is BPH (Benign Prostatic Hyperplasia)?
- 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.
- 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.
- 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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