Talking With Your Doctor About Enlarged Prostate


You are a man and, like most men, you aren’t that comfortable talking about your health. But if you live long enough or desire to live that long, you’ll have to talk about your health with your doctor. And later in life you are likely to have benign prostatic hyperplasia — about 80 percent of men will have BPH in their lifetime — and will need a urologist to either diagnose or confirm that you have the condition and then treat it.

What is BPH?

BPH means the prostate gland has grown so large that it is causing urinary problems. Often, as the gland enlarges, it presses on the urethra, narrowing or blocking it and making it difficult for urine to pass through the tube. Eventually BPH may cause bothersome and embarrassing urinary symptoms that may require specialized treatment.

You should see a urologist when:

  1. You are finding it problematic to start to urinate.
  2. You frequently have a sudden, uncontrollable urge to urinate.
  3. You have dripping or leaking of urine after you urinate.
  4. You have weak, slow or interrupted urine streams.
  5. You urinate frequently, particularly at night.
  6. You experience pain or discomfort or have to strain or push to urinate.
  7. You can’t empty your bladder completely.

Why should you see a urologist?

BPH should be promptly treated by a urologist because it can have adverse effects on your life. The condition can lead to complications such as urinary tract infections, kidney failure or urinary retention. Likewise, BPH may reach a point where you may have to plan every errand, activity or event you are attending around its proximity to a bathroom.

You also should see a urologist if you have a family history of the condition. The doctor will guide you on the actions to take to prevent or manage the condition, helping you avoid complications and make treatment more cost-effective. And since BPH and prostate cancer may have similar symptoms, speaking with your doctor about your symptoms may help you detect a more serious condition earlier.

How should you speak with a urologist?

Most problems brought to urologists are embarrassing. So rest assured that talking about BPH with the doctor is not a shameful, intimidating act but a courageous, lifesaving step. Don’t be reluctant to open up. Be willing to talk freely since the condition has a great prognosis if treatment begins early. Also there is a lot of value speaking with a urologist when the symptoms are still at their mildest stage because only a simple intervention may be needed. It is important to seek help as soon as symptoms begin to occur.

You should come to your appointment prepared with your complete medical history, medications and all the relevant information about your health and the procedures you have had in the past. You also should bring any information about your condition and a list of questions to ask.

Once you’re at the urologist’s office, make sure you are completely honest about the reasons for your appointment. Be open and say you are visiting because of your urinary problems. Honesty will help to prepare you and the entire urology team that will handle the case. It is also critical to talk about all the changes that you have seen in your health.

While treatment for BPH can be as simple as just avoiding alcohol and caffeine, emptying your bladder as completely as you can, or taking prescribed medication to reduce the symptoms, prevent further growth of the prostate or shrink the prostate, your primary focus should be on achieving an improved quality of life after treatment. Ask the urologist about the possible side effects of the potential treatments, the right treatment for you and how comfortable it will be for you moving forward. Whenever possible, seek non-surgical interventions first before you consider surgery.

If the condition can’t be controlled with medication, such as in severe BPH or when you have complications like bladder stones, urinary tract blockages or kidney problems, your doctor may suggest surgery. Various forms of surgery include laser therapy, transurethral prostatic incision, needle ablation or microwave therapy. It is important to speak with your urologist about the different surgical options before you are treated. For more information on diagnosis and treatment of BPH, visit the “Advanced-Urology-Institute‘” site.

Treating Prostate Cancer

Prostate cancer is one of the most common cancers among American men. In fact, it is the most frequently diagnosed non-skin cancer in men, with over 2 million American men currently living with the cancer. Statistically, a new case arises every 3 minutes, one in six American men has prostate cancer, while an American man dies of it every 19 minutes.

Making treatment decisions

At Advanced Urology Institute, we make every effort to deliver world-class treatment and care for patients with prostate cancer. After a diagnosis, our physicians review various treatment options before picking any treatment for the patient. We also conduct further studies, such as biomarker testing and imaging studies, to ensure that we have correctly established the stage or extent of the disease. We use this information to make the right decisions and give prostate cancer patients the most effective treatments. We choose treatment options depending on the cancer itself (high-risk, intermediate risk or low-risk) and patient factors (personal preferences, age and other health issues).

Prostate cancer treatment options

Advanced Urology Institute offers a wide range of innovative and effective diagnostic and treatment procedures for patients with prostate cancer. At the institute, newly diagnosed patients get the opportunity to meet and discuss their condition with renowned and experienced specialists on the same day.

Our treatment options include:

  1. Active surveillance: For a low-risk prostate cancer that may not harm a patient over the course of his lifetime, urologists at AUI usually recommend close observation. It often comes with secondary chemoprevention.
  2. Prostatectomy: Prostatectomy is a surgical procedure to remove the prostate. For localized prostate cancer, radical prostatectomy may be employed. However, at Advanced Urology Institute, we commonly apply the robot-assisted technique, which is a minimally-invasive, laparoscopic procedure.
  3. Radiation: An external beam of radiation is directed at the prostate in order to kill cancerous cells.
  4. Cryotherapy: Probes are inserted into the prostate gland to allow for the introduction of liquid nitrogen into the gland. Once administered, liquid nitrogen produces an ice ball inside the prostate which destroys cancerous cells.
  5. Brachytherapy: A radioactive seed is implanted in the prostate. The procedure involves inserting and removing the needles that are used to place radioactive seeds inside the prostate.
  6. Hormone therapy: Various medications can be administered to reduce or inhibit the secretion of testosterone hormone. Diminished quantities of testosterone means reduced or no growth of the cancer.
  7. Chemotherapy: Certain drugs may be used to boost the effectiveness of the other treatments, both for metastatic and localized disease.

Multi-disciplinary treatment and care

At Advanced Urology Institute, our goal is to cure prostate cancer while also maximizing the quality of life of our patients. We carefully weigh the benefits of every treatment option against the side effects and develop the most practical individualized treatment programs for all patients. We also believe that effective management of prostate cancer needs extensive collaboration. We have implemented a multidisciplinary approach to treatment that allows our various specialists, such as urologists, radiation oncologists, medical oncologists, radiologists, pathologists and clinical trial nurses to deliberate and get diverse, specialized perspectives before making treatment decisions for any patient. During AUI conferences, detailed discussions among experts help to clarify the benefits and risks of various diagnostic tests and treatment options, resulting in better treatment outcomes for our patients.

Advanced Urology Institute uses image-guided targeting, MRI, ultrasound and fusing 3-D guidance to boost the accuracy and usefulness of prostate biopsies. We also apply minimally-invasive, outpatient procedures in most cases. So, with our comprehensive consultation service and multidisciplinary approach that incorporates the latest technologies, research developments and expertise, all our patients can be sure of the best possible prostate cancer treatment. Want help with prostate cancer? Get more information from our “Advanced Urology Institute” site.

Most Common Forms of Prostate Diseases

Located just beneath the bladder and in front of the rectum, the prostate is a tiny gland in men that helps to make semen. It is a walnut-sized gland in young men which is wrapped around the tube carrying urine away from the bladder. The prostate grows larger with age, but when it becomes too large medical problems may arise. For men older than 50, the risk of having prostate related problems is quite high.

The most common prostate diseases are:

  • Prostatitis: Inflammation of the prostate, often caused by bacteria.
  • Enlarged prostate (BPH): Benign prostatic hyperplasia is a frequent problem in older men and is characterized by the frequent urge to urinate (especially at night) and dribbling after urination.
  • Prostate cancer: A common cancer in men which responds well to early treatment.

Benign prostatic hyperplasia (BPH)

This is the most common prostate disease found in men older than 50. BPH occurs when the prostate gland has enlarged to the extent of squeezing the urethra and obstructing the flow of urine from the bladder. Benign prostatic enlargement only means the prostate has enlarged, but there is no cancer. It is treated using active surveillance or watchful waiting when symptoms are not severe, but medications or surgery may be needed in severe cases. Other treatments such as microwaves, radio waves and lasers also may be used.

Prostatitis

Inflammation of the prostate (prostatitis) is frequent in men older than 50. There are three forms of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis and chronic prostatitis. Acute bacterial prostatitis has sudden onset after a bacterial infection and is characterized by chills, fever and pain in addition to other prostate symptoms. A combination of antibiotics and pain medication may relieve the problem.

Chronic bacterial prostatitis is a recurrent bacterial infection of the prostate. It can be relieved by taking certain medications for a long time, but you contact your doctor immediately when symptoms occur. Chronic prostatitis (also known as chronic pelvic pain syndrome) is a common problem which causes pain in the groin, lower back and tip of the penis. It may be treated by a combination of medication, surgery and lifestyle changes.

Prostate cancer

It is the most frequent cancer diagnosed in American men, affecting almost 50 percent of men older than 70. An estimated 200,000 men are diagnosed with the cancer in the U.S. every year, but many men can live with it without problems as it causes few symptoms unless it has spread to other areas of the body. The risk of getting prostate cancer depends on age (men older than 50 are at higher risk), race (African-American men are at higher risk than Native-American), family history (you are at higher risk if your father or brother had it) and diet (more common in men who eat high-fat diets). It is highly curable when detected early. Prostate cancer is diagnosed using a digital rectal exam or prostate-specific antigen (PSA) test. Treatment options include watchful waiting, surgery, radiation therapy and hormone therapy.

Symptoms of prostate disease

You should visit your doctor if you have any of these symptoms:

  • Frequent urge to urinate
  • Painful or burning urination
  • Need to urinate several times at night
  • Painful ejaculation
  • Dribbling of urine
  • Blood in urine/semen
  • Frequent stiffness or pain in lower back, pelvic area, hips, upper thighs or rectal area

At Advanced Urology Institute, we have experienced physicians and state-of-the-art facilities for diagnosis and treatment of prostate diseases. If you have any of the symptoms above, visit us for help. For more information, visit the site Advanced Urology Institute.