Caring for an Enlarged Prostate

Benign prostatic hyperplasia (BPH) refers to a non-cancerous growth of the prostate gland that happens to most men as they grow older. This enlargement may lead to a variety of urinary symptoms including a weak urinary stream, difficulty starting the stream, frequent urination, urgent urination and arising from sleep to urinate. In more serious situations, BPH can cause a complete inability to urinate, infection, bladder stones or failure of the bladder or kidneys to function properly. It is very important for all men over the age of 50 to have their prostate checked at least once per year to make sure there are no signs of cancer. Once it has been established that cancer is not present, a variety of approaches may be used to try to relieve the symptoms associated with an enlarged prostate.

In most cases, the primary goal of treatment of BPH is improvement in the quality of life of the patient. Therefore, it is most commonly up to the patient how they would like to proceed when it comes to treatment. For many men, no treatment of BPH may be appropriate. For others, simply altering fluid intake and other behavioral changes may be all that is needed. For those men with more severe symptoms, a variety of medications are available to treat an enlarged prostate.

In addition, several natural remedies, such as saw palmetto, may be tried once it is clear that there are no signs of cancer and infection. At the University of Chicago Medicine, we have conducted several widely recognized studies using saw palmetto and other natural remedies for BPH. These have generally demonstrated mild to moderate improvement in symptoms without any apparent side effects.

For those patients who do not respond to medication, several procedures are available to treat an enlarged prostate. These include the traditional transurethral resection of the prostate (TURP), laser procedures, microwave procedures, as well as several others. Our urology specialists continue to explore new and better ways to treat men with BPH, with an emphasis on tailoring therapy to the individual patient's needs and desires.

Greenlight Laser for BPH

The treatment for men with enlarged prostates and difficulty urinating has evolved greatly during the past five to 10 years. One of the most exciting developments has been photovaporization of the prostate (PVP) using the Greenlight laser.

This technique allows for the direct removal of prostate tissue, similar to what occurs during the more traditional transurethral resection of the prostate (TURP). However, since the tissue is vaporized using the laser, bleeding is minimal. That allows most patients to go home from the hospital on the same day as the procedure, often without the need for a urinary catheter.

This technique has a distinct advantage compared to microwave therapy (TUMT) or transurethral needle ablation (TUNA). It can take several weeks or months for the prostate to decrease in size following those treatments.

Greenlight laser results are similar to those achieved with a TURP, which has been the gold standard for treating men with enlarged prostates for decades. However, the Greenlight's laser has fewer negative side effects and a shorter recovery period.

The vast majority of men who have had the Greenlight procedure at UChicago Medicine have been overwhelmingly satisfied with the results. The most common comment is that patients wish they had not waited so long to have it done.