Dr. Lievano is a Urology doctor serving the DFW metroplex. His primary office location is at Baylor Scott & White in Fort Worth, Texas.
The prostate gland is found below the bladder in males. This small gland can cause a whole host of problems. It surrounds the urethra, creating urinary issues if it is enlarged or affected by cancer. All males are at risk of prostate problems, but getting older can increase your chances of having issues with this gland.
Recommended Dallas-Fort Worth Prostate Doctors
One of the most common prostate problems is an enlarged prostate. Also known as benign prostatic hyperplasia (BPH), this condition causes the gland to grow to a detrimental size.
Approximately one in 12 males between the ages of 31 and 40 are affected by this condition. One in two men between the ages of 51 and 60 have an enlarged prostate.
It’s natural for the prostate to grow to some degree as men get older. Hormones may partially influence the condition, but they’re not solely responsible. In fact, the first stage of prostate growth occurs during puberty. It begins to grow again around age 25 and gradually increase in size for the rest of a man’s life.
Only about 50 percent of men with BPH have symptoms. If you don’t experience symptoms, you may not need surgery. Mild BPH may be treated with medications, and hormone therapy is often used to reduce the likelihood that the prostate will grow with age.
When symptoms do occur, the most common include:
- Frequent urination
- Weak urine stream
- Constant urge to urinate
- Urine leakage
- Dribbling urine
- Straining to urinate
- Feeling of incomplete bladder emptying
Another symptom is the inability to empty the bladder completely. If this occurs, you may develop urinary tract infections regularly. You may see blood in the urine or develop bladder stones. Rarely, kidney or bladder damage can occur.
Enlarged Prostate Diagnosis
It’s not always evident that your prostate is to blame, but anytime you have trouble urinating, you should visit a urologist. The doctors in the Dallas Fort-Worth area can adequately diagnose and treat your condition.
During an exam, many doctors try to rule out other dangerous conditions before diagnosing BPH. Physicians utilize the BPH Impact Index to determine whether your symptoms require treatment.
If your symptoms are mild, most doctors implement the “watch and wait” approach. Regular visits to your urologist are essential for determining whether to begin a treatment program.
Minimally Invasive Treatments For BPH
Although you can try medications for an enlarged prostate, people with troublesome symptoms may wish to try minimally invasive treatments. These may offer quicker results than drugs.
Transurethral Microwave Thermotherapy (TUMT) helps remedy urinary blockages in men with mild to moderate prostate enlargement. It can relieve symptoms of BPH such as urinary urgency, straining, and frequency. However, it isn’t effective for treating problems related to bladder emptying.
During this outpatient procedure, a small antenna is inserted into the urethra until it reaches the area that is encircled by the prostate. Then, computer-controlled microwaves are emitted to heat and destroy the part of the prostate that hinders the flow of urine.
TUMT offers a lower risk of bleeding than surgery. It also prevents you from having to stay in the hospital. You can go home the same day as your treatment. However, if your symptoms don’t improve or return, you may have to repeat the procedure.
Transurethral Radio Frequency Needle Ablation (TUNA) uses high-frequency radio waves that are directed into the prostate via a needle. This also destroys prostate tissue in an effort to improve urinary symptoms.
Surgery For Enlarged Prostate
All treatments for BPH come with some side effects. Surgery is often the most effective method for treating the problem, but it comes with the biggest risks.
Modern technology has diminished the risks of prostate surgery, however. Robotic surgery is less invasive than open surgery.
The most common BPH surgery is Transurethral Resection of the Prostate (TURP). This is considered to be the gold standard of prostate surgery options and is performed in a hospital. Urologists will use a tool that allows them to see the prostate as well as cut out the portion that affects urinary flow.
TURP offers direct access to the prostate. Extra tissue can be removed immediately, and other conditions, such as bladder stones, may be remediated simultaneously. This procedure is taught in medical schools, and most surgeons have a great deal of experience performing TURP.
Photoselective Vaporization of the Prostate, or PVP, with a GreenLight laser, is a minimally invasive treatment that vaporizes the overgrowth of prostate cells. This fast, accurate procedure is an alternative to TURP.
During the procedure, a laser is directed at the prostate. This heats the blood, causing adjacent cells to vaporize.
GreenLight Laser PVP is associated with fewer side effects than TURP. Patients can usually go home the next day. Bleeding is minimal, and only about one-third of patients who undergo the procedure requires a catheter after the operation. The recovery time for GreenLight Laser PVP is shorter than with TURP.
A simple prostatectomy can also remove a portion of the prostate. This surgery may be used to treat an extremely enlarged prostate in males who aren’t good candidates for TURP or GreenLight Laser PVP. When a simple prostatectomy is done using laparoscopic surgery, smaller incisions can be made than during open surgery. Cameras, lights and surgical tools are inserted into these keyhole incisions to remove the prostate core.
The most common type of surgery for prostate cancer is a radical prostatectomy. This involves removing the entire prostate, including surrounding tissue. Although open surgery used to be the most popular way to approach this procedure, it is often performed with laparoscopic or robotic surgery nowadays.
Some of the advantages to laparoscopic surgery include minimized blood loss, reduced pain, shorter hospital stays and reduced recovery time. Robotic surgery offers the surgeon better precision while doing the procedure.
A catheter is often, but not always, required after prostate surgery to help the urinary tract relax. Some men have painful urination following prostate surgery. However, these procedures have a high success rate. Talk to a urologist today to determine whether prostate surgery is the best option for you.