It's a common medical issue, but it's rarely discussed.
"By age 50, about 40 percent of guys already have a bigger prostate," said Dr. James Tycast, who practices at Northwest Urology, located at the Providence Sherwood Medical Plaza, said. "By age 70, it's almost 80 percent of guys. It's a disease process of older guys, because the longer we live, the more the prostate tissue has the opportunity to grow."
Symptoms of an enlarged prostate can vary, but a man usually notices problems such as urinary frequency and urgency. A patient may also feel that the bladder is not emptying completely.
"The other big one (symptom) is getting up a lot at night (to urinate)," Tycast said. "You start to notice quality-of-life changes where some people get some anxiety about whether or not they're going to be near a bathroom."
Tycast, a urologist, is using a new technique, known as UroLift, to treat BPH, also called benign prostatic hyperplasia. It's a minimally invasive procedure that allows a patient to experience normal urine flow in a few days.
Traditional treatments for BPH include medications and, in some cases, a process called TURP, or transurethral resection. Doctors remove excess prostate tissue through the urethra using a scope. This resection surgery is done at a hospital and requires anesthesia. Bleeding can occur with TURP, and patients would need a catheter.
Medications can have side effects, according to Tycast.
"Sometimes you can have dizziness," Tycast said. "Sometimes you can have some erectile dysfunction from those. You can have some decreased libido from these medications."
The idea behind UroLift is to open the prostate, and keep it open, with clips, a procedure that also involves a scope through the urethra. As uncomfortable as this may sound, a local anesthetic, or numbing jelly, is injected into the urethra. Once the channel in the prostate is opened, urine will flow more freely through the urethra.
UroLift can be performed in the office, and there is no need for hospitalization. With this relatively new procedure, a patient can "respond much more rapidly and you're back on your feet, back doing your normal stuff. That's huge for patients," Tycast said.
UroLift is an option for patients who would prefer to avoid medications.
"A lot of people don't want to take medications anymore," Tycast said. "Medications we do have have been around a long, long time."
UroLift, he added, "opens the door for us to treat a lot more guys — it's a game-changer in that we have something new we can do that works. That's exciting as a doctor."
One of Tycast's patients, 70-year-old Beryl Terry of Newberg, has seen the positive benefits of the procedure.
Terry noticed urinary difficulties about four or five years ago.
"I put up with it, like every man," Terry said. "It's kind of halfway embarrassing to talk about it with anybody. As time went on, it got worse. I went to my family doctor and told him I was getting up four or five times a night."
After a visit to the family doctor, Terry was placed on a medication, which didn't seem to resolve the problem. Terry was then sent to Tycast for further evaluation and eventually underwent the UroLift procedure.
"He did the procedure," Terry recalled. "About two days after he did the procedure, I was like a new man. From then on, I slept through the night — it was phenomenal."
Although Terry experienced a little bleeding for a few days, he said, "After that, there's no hurt — you go to the bathroom like normal. It's like being 40 years old again, or 35."
Men may be reluctant to bring up prostate or urinary issues with their primary care physicians. But it's important for men to be proactive.
"What we want to do is get you on the early side, so we can fix you early," Tycast said. "Long-term outcomes for you are so much better. As guys, we need to get out there and be a little bit more outspoken for ourselves."
Terry is also a firm advocate of being proactive. He reminds his fellow men, "Don't be embarrassed about going to your doctor."
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