prostate-enlargement

Prostate enlargement solutions are addressed with lifestyle changes, prescribed medicine, alternative medicine or home remedies, minimally invasive procedures and prostate removal surgeries. Simple solutions may help reduce prostate enlargement symptoms such as reduce fluid intake in the evening hours prior to going to bed and urinating just before sleeping. One of the most common complaints of BPH is the need to wake up during the night to go to the bathroom (nocturia), so reducing fluid intake and voiding at bedtime may reduce your nightly trips to the bathroom. When you feel the need to go, then go, do not put it off. You also may benefit by making sure you urinate every 4 to 6 hours whether you feel the need to go or not. To help you empty your bladder more completely, void standing up. These simple changes may help reduce your frequent urination.

Prostate enlargement solutions may include alternative or natural medicines that many people try before using prescription meds. There are many natural options available and they may have some effect, but potency is not as accurate as prescribed medicine. Common alternatives are saw palmetto, pygeum, and stinging nettles for BPH.

According to your medical history, your symptoms and your voiding patterns (it is best to keep a diary of your voiding patterns for your visit to the doctor) our urologists may prescribe some medicine to help you empty your bladder. These medicines will either help the prostatic urethra (area of the urethra that is surrounded by the tightening prostate) and bladder neck relax, or they will help to shrink your prostate.

Often our urologist will see fit to give you both types of medications since they have been found to work well together. It is important to remember that both alternative/natural medicine and prescribed medicine may need weeks and even months to work, so do not stop taking them after a few days because you have not seen any result. You should call the doctor if you experience any side effects once you start taking your medication.

 

Prostate Enlargement Procedures

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Prostate enlargement procedures are all focused on opening up the prostatic urethra, since the growing prostate makes the urethra passage smaller and smaller, as it tightens around the urethra the larger it gets. One such procedure is called a transurethral incision of the prostate or TUIP. Our urologists will make a slit or two in the prostatic urethra to open up a passage for the urine to pass out. This is done for prostates that are only slightly enlarged. 

Prostate enlargement procedures usually try to remove the prostate tissue so the urethra is no longer compressed by the prostate. The traditional procedure is called transurethral resection of the prostate or TURP. You may have heard of it as a roto-rooter since it is compared to clearing out the pipes (although the prostate is on the outside of the “pipes” urethra). Our urologists will use a hot wire and cut (sometimes described as scrap) out the prostate that is pressing on the urethra. This procedure is performed in the operating room under anesthesia and results are generally good (this procedure is the standard that the other procedures are compared too). You should be able to empty your bladder completely within a couple days.

There is a prostate enlargement procedure that is performed in the office and takes about 15 minutes; it is called radio frequency therapy.  Men will opt for this office visit procedure because it is fast, there is minimal anesthesia, it is covered by insurance, there is no hospital stay, and it is convenient. Radio frequency waves remove prostate tissue in different areas of the urethra allowing it to open up and allow all the urine to empty from the bladder.

Prostate enlargement procedures have culminated into laser surgery. The most recent laser to remove prostate tissue is called the green light laser. The difference between the transurethral resection of the prostate and the green light laser is that the laser vaporizes the prostate tissue whereas the TURP cuts and cauterizes the tissue. Less bleeding occurs during a green light laser procedure.

 

Prostate Enlargement Surgery

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Prostate enlargement surgery is the removal of the entire prostate. This is rarely done for prostate enlargement; it is normally done for prostate cancer. Occasionally a prostate may grow so large that it interferes with other parts of the anatomy, bladder stones may always be present, or the bladder may become damaged. In these cases prostate removal may be the best solution.

This particular prostate enlargement surgery is called a radical prostatectomy. This surgery may be performed with three different surgical methods. The first is with the classic open surgery where our urologists will make a slit in the abdomen and manually perform the surgery that removes your prostate. The second surgery is performed with laparoscopic instruments through several small holes in the abdomen.

Our surgeons view the surgery on a monitor that shows the view of a camera that is on the end of one of the laparoscopic probes. This laparoscopic surgery or laparoscopic prostatectomy may offer less scarring, less bleeding, and a shorter time in the hospital.

Prostate enlargement surgery has evolved into a robotic surgery. Dr Fernando Bianco who is the Chief of Robotic Surgery for the Columbia University Division Urology at the Mount Sinai Medical Center performs this third type of prostate removal surgery that is called da Vinci prostatectomy. It is performed with laparoscopic instruments but instead of the surgeons holding the laparoscopic probes by hand for hours, the entire surgery is controlled by Dr Bianco from a seated console. Some of the benefits that doctor Bianco has by using the Da Vinci surgical system include a magnified view of the surgical site. The da Vinci system gives Dr Bianco a 3 dimensional view which allows him to anticipate as he moves the scalpels, cautery, suction, camera, and other surgical instruments around the organs, blood vessels, nerve bundles and tissue.

Prostate enlargement surgery with the robotic system also removes the natural shaking movement of the human hand. The sensors of the robot allows for gentle pressure when touching the tissue. The controlling hardware and software make micro fine movements and the surgical instruments can circle 180 degrees. This 180 degree and micro fine movement is superior to human capabilities. When you add on top of that the optical enhancements of a magnified and 3D view this third method of surgery has many benefits over the open and laparoscopic surgeries. This newest robotic technique takes surgeons many surgeries to become an expert robotic surgeon. Dr Bianco has researched robotic surgical outcomes using the number of robotic surgeries the surgeon has performed as the variable. Dr Bianco has performed hundreds of robotic surgeries and trains our urology fellowship and visiting urologists. All these superior resources are why having a nerve sparing robotic prostatectomy to keep the urinary and sexual functions intact should be done here at the Ivy League urology center. Click here for an appointment.