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YOUR HEALTH: A laser solution to enlarged prostates

It's a new, minimally invasive way to help men suffering from an enlarged prostate.

DALLAS — By the time they reach 50-years-old, 30% to 50% of men will experience benign prostatic hyperplasia or BPH, also known as an enlarged prostate. 

It can be debilitating and make it almost impossible for these men to urinate. 

If left untreated, the prostate will continue to grow, along with the problem. Now a new treatment is helping to clear the way and get these men going again. 

"Prostate problems can be pretty serious," said Dr. Marawan El Tayeb, a urologist at Baylor Scott and White Health based in Dallas.

"It starts with mild symptoms," he added. "It can progress pretty serious into urinal retention and, a complete, inability to urinate. After that, it can progress to renal failure."

El Tayeb sees up to 20 men a day suffering from enlarged prostates.

The first line of treatment is medication. 

If that doesn't work, doctors progress to minimally-invasive treatments.

And one of the newest, most effective procedures is the HoLEP, a type of laser surgery used to open up any blockages and remove the enlarged prostate tissue.

"You can imagine the prostates like an orange with the peel outside and the fruit inside. Basically, we go around the fruit, taking it out of the peel, and leave the patient with a very nice open channel for them to urinate," El Tayeb explained.

The HoLEP laser surgery is available at the Mayo Clinic

Seventy percent of patients leave the hospital the same day, 95% will have the catheter removed the following day.

"So, (the) patient will feel the benefit as soon as the catheter comes out, they will start feelings that they are much better," El Tayeb said. "The stream is much better, and they will feel immediate benefit."

Some possible, but rare side effects include temporary burning or bleeding during urination and urinary incontinence immediately after surgery. 

An enlarged prostate can be caused by BPH, but also can be caused by prostate cancer, which affects one in six men in the United States. 

An alternative to surgery being studied

Physicians at UC San Diego Health are now offering prostate artery embolization (PAE) as a new treatment option for men with BPH.

The minimally invasive procedure is an alternative to surgery, with no hospital stay, little operative pain and lower cost. 

UC San Diego Health interventional radiologists and urologists screen patients as potential candidates for PAE. 

Typically, candidates are 50 to 85 years of age, have urinary tract symptoms, have unsuccessfully tried medications within the last six months and have undergone assessment for prostate cancer risk. 

Diagnosing the problem

Although benign prostatic hyperplasia rarely causes symptoms before age 40, the occurrence and symptoms increase with age. 

Benign prostatic hyperplasia affects about 50% of men between the ages of 51 and 60, and up to 90% of men older than 80, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Some symptoms of an enlarged prostate to look out for include but are not limited to: 

  • a weak or slow urinary stream
  • a feeling of incomplete bladder emptying
  • difficulty starting urination
  • frequent urination
  • getting up frequently at night to urinate
  • a urinary stream that starts and stops

If you notice any of these symptoms, it's important to contact your primary physician as soon as possible. 

Tests such as urine flow study, digital rectal exam, prostate-specific antigen (PSA) blood test, cystoscopy, ultrasound or prostate MRI may be used to confirm the diagnosis. 

Treatment for BPH may depend on the severity of the symptoms and range from no treatment to medication or surgery. 

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

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