Benign Prostatic Hyperplasia (BPH)
BPH is not simply a case of too many prostate cells. Prostate growth involves hormones, occurs in different types of tissue (e.g. muscular, glandular), and affects each man differently. Because of these differences, treatment will vary in each case. Once prostate growth begins to compromise urinary flow, it often continues unless medical therapy is started. The prostate grows in two ways. In one type of growth, cells multiply around the urethra (urinary drainage tube) and squeeze it, much like squeezing a straw. The second type of growth is middle-lobe prostate growth in which cells grow into the urethra and the bladder outlet area. This type of growth typically requires surgery or office thermotherapy to restore normal urinary flow.
Incidence and Prevalence
It is difficult to establish incidence and prevalence of BPH because research groups often use different criteria to define the condition. According to the National Institutes of Health (NIH), BPH affects more than 50% of men over the age of 60 and as many as 90% of men over the age of 70.
Dr. Cornell has facilities to diagnose and treat BPH. These services include:
Urodynamic Testing
A full in-office evaluation of bladder function used to diagnose overactive bladder (OAB), urinary incontinence, bladder outlet obstruction, and to direct treatment options.
Medical Treatment
There are several medical and surgical treatment options for men with BPH, depending on the severity of symptoms. If symptoms do not threaten the man’s health, he may choose not to be treated. If symptoms are severe enough to cause discomfort, interfere with daily activities, or are associated with lower urinary tract infection, treatment is usually recommended.
Medications taken before bedtime can improve urinary flow and, over time, actually shrink the prostate and promote low-pressure, complete bladder emptying.
Office Thermotherapy
Transurethral needle ablation (TUNA) Prostiva radiofrequency thermotherapy often represents the next step in BPH treatment when medication fails to relieve obstructive symptoms. The procedure is performed in the office in about 20 minutes. Typically, only local anesthesia with mild oral sedation is required for the office procedure. TUNA can be used in patients with metal implants and cardiac pacemakers and defibrillators who may not be candidates for microwave thermotherapy (TUMT) or other minimally invasive options. TUNA is designed to permanently reduce BPH symptoms in one treatment session and is the modality which I have chosen to perform in my office, given its excellent treatment outcome and the absence of irritative voiding symptoms or bladder thermal injury which complicates other treatment options.
Pelvic Anatomy
