Prostate Health

It is not clear why some men develop more severe BPH than others. However, age and hormones play a role. As men get older, testosterone levels fall while a hormone called dihydrotestosterone, or DHT, builds up in prostate tissue. DHT impacts prostate cell growth, and over decades, that buildup adds up.

Symptoms of BPH can come from the prostate pressing on the urethra and slowing urine flow. Other symptoms can come from the bladder reacting to that pressure over time. Symptoms include:

• A sudden, urgent need to urinate
• Feeling like the bladder is not fully empty
• Leaking or dribbling after urination
• Stopping and starting during urination
• Trouble getting started
• Waking up to urinate two or more times a night
• Weak or slow urine stream

Treatment depends on how much your symptoms bother you, your overall health, and how it affects your daily life. Often, treatment begins with a less invasive approach.

• Watchful Waiting - If your symptoms are mild and not getting in the way of daily life, we may simply watch and wait.
• Medication – two main types of medication treat BPH.
  • Alpha-blockers relax the muscles in the prostate and bladder neck. This makes it easier to urinate. Most men notice a difference within days.
  • 5-alpha reductase inhibitors block the hormone that impacts prostate growth and can actually shrink the prostate over several months. This works best in men with significantly enlarged prostates.
• Minimally Invasive Procedures
• The prostatic urethral lift, or UroLift®, uses small implants to hold prostate tissue away from the urethra.
• Water vapor therapy, called Rezum™, uses steam to reduce prostate tissue. Prostatic arterial embolization shrinks the prostate by reducing its blood supply.
• BPH Surgery - When symptoms are severe or other treatments have not worked well enough, BPH surgery may be recommended.
• Transurethral resection of the prostate, or TURP, has been the standard procedure for decades. The surgeon removes the inner part of the prostate through the urethra. Most men experience significant improvement.
• Laser options, including HoLEP and GreenLight vaporization, offer similar outcomes.

Some men may experience flu-like symptoms. Others may have been living with a low-grade pelvic ache for months. Symptoms may include:

• Cloudy urine or blood in the urine
• Difficulty starting or maintaining urine flow
• Frequent or urgent need to urinate
• Pain during or after ejaculation
• Pain in the perineum, the area between the scrotum and rectum
• Pain or burning during urination
• Pelvic pain or discomfort in the lower abdomen

Treatment for prostatitis can vary and will depend on the type you have and how severe it is. Treatments may include:

• Antibiotics — The standard treatment for bacterial forms.
• Alpha-blockers — Medications that relax the muscles of the bladder neck and prostate can help make urination easier and reduce discomfort.
• Anti-inflammatory medications — NSAIDs help manage pain and inflammation.
• Warm baths — Soaking in warm water can help with pelvic discomfort and muscle tension.
• Diet changes — Consuming less caffeine, alcohol, spicy foods and acidic beverages can reduce bladder and prostate irritation for some men.
• Physical therapy — Pelvic floor physical therapy can help address muscle tension that contributes to chronic pain.

The exact cause of prostate cancer is unknown; however, certain factors may increase a man's risk for the disease. The most common risk factors include:

• Age: The risk increases as men get older. Most prostate cancers occur in men older than 65.
• Race/Ethnicity: There is a higher risk for African American men and men of Caribbean descent.
• Family History: Men are more likely to develop prostate cancer if they have a family member with the disease.

In the early stages, prostate cancer often has no symptoms. As it progresses, symptoms may develop including:

• Frequent urination, especially during the night
• Difficulty starting or stopping the flow of urine
• Inability to urinate
• Pain or burning during urination
• Blood in the urine (hematuria)
• Painful ejaculation
• Weak urine flow
• Pain in the lower back, hips, or upper thighs

Treatment for prostate cancer can range from active surveillance to watchful waiting. Other treatment options include:

• Surgery
• Radiation Therapy
• Systemic Therapies such as hormone therapy, chemotherapy or immunotherapy
• Targeted therapy
• Laser Ablation

Learn more about the advanced care and treatments options for prostate cancer.