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Symptoms of BPH

At Urological Consultants of Florida, our board-certified urologists specialize in the treatment of men suffering from symptoms of BPH or enlarged prostate.  Our urologists offer the latest medical and surgical treatment options for men with bothersome prostate symptoms.  Dr. Robbins has been teaching surgical techniques all over the world since 2012 and is a member of the Boston Scientific Strategic Advisory Board for BPH, leading the future of BPH therapy and surgical options including GreenLight laser and REZUM.   Additionally, given his expertise in minimally invasive surgery for enlarged prostate, Dr. Robbins was asked by Procept BioRobotics to be the first urologist in South Florida trained on Aquablation therapy for enlarged prostate with the Aquabeam system.  As of January 2019, he is the only urologist in South Florida trained and able to offer this cutting edge BPH treatment.  

What are the symptoms of BPH?

When the prostate grows and obstructs the urine flow out of the bladder, the following BPH symptoms may result:

  • Slow urinary flow and dribbling of urine
  • Waking up at night to urinate 2 or more times making sleep difficult
  • A feeling of bladder fullness even right after going to the bathroom
  • Hesitancy of urination having to wait for the stream to start
  • Urgency of urination- the feeling of needing to urinate immediately and a man might not make it in time
  • Urinary Incontinence- a leak of urine prior to making it to the bathroom resulting in embarrassment
  • Urinary Frequency- having to go to the bathroom more often than in the past, not making it through a movie without using the bathroom
  • Incomplete emptying- leaving a significant residual volume of urine in the bladder after urination

Why do some men experience symptoms of BPH while others do not?

As men age, the prostate will naturally increase in size due to genetic and environmental factors.  The prostate sits between the bladder and urethra and acts like a vice around a garden hose. Increasing size and internal compression of the urethra from prostate growth or BPH results in obstruction of the flow of urine.  Over time, urinary obstruction causes the bladder to have to work harder to empty resulting in many of the symptoms of BPH or enlarged prostate listed above.   Just as some men are tall or short, prostates can grow to different sizes and with variable anatomy.  Prostate sizes in men can range from 15 mL to greater than 300-400 mL.  There is typically a direct relationship between prostate size and BPH symptoms.  Additionally, whereas all men have lateral lobes of the prostate that may obstruct the flow of urine from the sides, some men develop a median lobe which is a third component of the prostate that sits posteriorly at the bladder neck and can block the outflow of urine from the bladder outlet like a ball valve.  These men typically require surgical management for their BPH symptoms.  There are even some men with very small prostates, but with an elevation of the bladder neck or median bar that can cause obstruction and significant symptoms.  These men may respond to medical therapy or TransUrethral Incision of the Prostate (TUIP).

Why do some men seek help for BPH symptoms and others do not?

Some men with mild symptoms of BPH may not seek an evaluation with a urologist.  They may alter their daily activities such as making sure they know where bathrooms are located in the places they typically hang out or work at.  They may avoid caffeinated beverages and decrease their intake of fluids.  However, at some point their enlarged prostate symptoms become burdensome and negatively impact their activities of daily life.  They may experience interrupted and incomplete sleep leading to daytime drowsiness, inabilty to attend social activities for fear of not being able to make it to the bathroom and a decreased sense of well-being.  Some men do not seek assistance until they have medical emergencies from BPH such as urinary retention, acute kidney injury, urinary tract infections, sepsis, bladder stones or hydronephrosis.  

What treatment options are available to treat my bothersome BPH symptoms?

Medical Treatments for BPH:

  • Alpha blockers- flomax, uroxatral, rapaflo, hytrin, cardura
  • 5 Alpha reductase inhibitors- proscar, avodart
  • Anticholinergics- Ditropan, Vesicare, Toviaz
  • Muscarinic Agonists- Myrbetriq

Surgical Treatment Options for BPH:

Tissue Removal Surgeries:

  • TURP- using monopolar or bipolar loop to resect chips of prostate tissue 
  • GreenLight Laser- laser energy used to photovaporize prostate tissue
  • Aquablation- image guided waterjet tissue resection
  • Button Vaporization- Bipolar button used to remove tissue
  • Open or robotic suprapubic prostatectomy- bladder is opened and prostate tissue is manually removed

Non- Tissue Removal Surgeries - Minimally invasive Surgical Therapies (MIST)

  • Rezum- thermal energy in water vapor (steam) is used to treat prostate tissue
  • Urolift- prostate tissue is tacked to its capsule to open up the prostate channel

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Our North Miami Location

12411 Biscayne Boulevard
North Miami, FL 33181

Contact:Phone: (305) 672-4222 Fax: (305) 944-3624

Hours:
Monday - Friday: 9am - 5pm
Saturday: Closed
Sunday: Closed

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