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Understanding and Managing an Enlarged Prostate (BPH)

man holding hands over prostate
July 18, 2024

Welcome back to the Balls Deep podcast, where we blend humor and medical insight to help you perform at your best in the bedroom, bathroom, and boardroom. Dr. Joe Pazona, a board-certified urologist, and his co-host Cat Williams, are diving into a common but often misunderstood issue: an enlarged prostate, or benign prostatic hyperplasia (BPH).

What is an Enlarged Prostate?

The prostate is a small gland in men, about the size of a ping pong ball in young men, located below the bladder and in front of the rectum. As men age, the prostate often enlarges, becoming more like a kiwi or even an apple in size. This growth can lead to the prostate pressing on the urethra, causing various urinary symptoms. It's important to distinguish that the prostate doesn't grow uniformly like a balloon; instead, it expands internally, causing the urethral passage to narrow.

Symptoms of an Enlarged Prostate

Men typically experience two types of symptoms: irritative and obstructive.

Irritative Symptoms:

  • Nocturia: Waking up multiple times at night to urinate.
  • Frequency: Needing to urinate more often than every two hours.
  • Urgency: A sudden, strong need to urinate, often leading to dribbling if not addressed quickly.

Obstructive Symptoms:

  • Weak Stream: Difficulty starting urination and having a weak urine stream.
  • Dribbling: Leakage of urine after finishing.
  • Incomplete Emptying: Feeling that the bladder isn’t completely empty after urinating.

Causes and Risk Factors

Several factors contribute to BPH, including age and hormonal changes. The condition can be exacerbated by lifestyle choices such as high fluid intake, particularly of caffeinated or alcoholic beverages, and uncontrolled medical conditions like diabetes.

Diagnosis and Treatment Options

Lifestyle and Medications

Lifestyle Modifications: The first line of treatment involves lifestyle changes, such as reducing fluid intake before bedtime and managing diabetes or sleep apnea.

Medications: If lifestyle changes are insufficient, medications like alpha-blockers and 5-alpha reductase inhibitors are considered. Alpha-blockers relax the prostate muscles to improve urine flow, while 5-alpha reductase inhibitors shrink the prostate by reducing hormonal stimulation.

Supplements: Over-the-counter supplements like saw palmetto are popular but lack strong scientific evidence supporting their effectiveness.

Surgical Options

Urologist Discussing Male Urology Issues and How to Address

For those who don't respond well to medications or have significant symptoms, surgical options are available.
UroLift: This is a minimally invasive procedure that uses implants to hold the enlarged prostate tissue away from the urethra, improving urine flow without cutting tissue. It's quick, has minimal side effects, and is suitable for men with smaller prostates.

Aqua Ablation: This is a newer technique using water jets to precisely remove prostate tissue under real-time ultrasound guidance. This method is heat-free, reducing the risk of damage to surrounding tissues and preserving erectile function and continence.

When to Seek Help

If you notice changes in your urinary habits, such as increased frequency, urgency, or nocturia, it's important to consult a urologist. Early intervention can prevent long-term damage to the bladder and ensure a better quality of life.

Conclusion

Understanding BPH and its symptoms can help men take proactive steps toward managing their health. Whether through lifestyle changes, medications, or surgery, there are effective treatments available. Always consult with a healthcare provider to find the best approach for your specific situation.

Just the Tip: Key Takeaways

  1. The prostate can enlarge and block urine flow, causing irritative and obstructive symptoms.
  2. Start with lifestyle changes and medications before considering surgery.
  3. Minimally invasive surgeries, like UroLift and Aqua Ablation, offer effective long-term relief with fewer side effects.

Thank you for tuning in to this episode of Balls Deep. Remember, your health is crucial, so don’t ignore the signs of an enlarged prostate. Get more more information about BPH and how we can help.

Disclaimer: The purpose of this podcast is purely informative and does not replace professional advice from medical experts. Please consult your healthcare provider about any symptoms or conditions you may have.

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