The Hubbard Clinic > Male Care > BPH/Voiding Problems

The ConditionThe TreatmentCommon MedicationsProceduresProstate Health

Do you have the following symptoms?

Frequent & urgent need to urinate
Getting up at night to urinate
Difficulty starting urination
Weak urine stream
Feeling that the bladder is still full after urinating
Interference with Sexual Function

If so, you may be suffering from an enlarged prostate, also known as Benign Prostatic Hyperplasia (BPH). BPH is an age related condition that causes prostate cells to enlarge, which causes compression on the urethra making urination difficult or painful.

On the first office visit, you will receive a general prostate exam, urine test, PSA blood test and painless tests to determine bladder retention and urine flow. If applicable, you will be placed on a two-week trial of medication to see if your symptoms improve. If needed, a more detailed examination will be scheduled.

The second visit will consist of a cystoscopy and prostate ultrasound to determine the size and degree of prostate blockage. To ease discomfort, you have the option to have this procedure done under local anesthesia and oral pain medication. Pending the results of the cystoscopy, a detailed treatment plan will be developed to treat your prostate.

The most successful treatments for BPH are minimally invasive procedures that are performed in our office. The type of procedure you will receive depends on the size and degree of your prostate blockage. The procedure (TUNA) is performed PAIN FREE under anesthesia administered by a Certified Registered Nurse Anesthetist. Other treatment plans include diet modification, medication and invasive surgical procedures. Our goal is to perform the most successful treatment in the most comfortable manner possible.

The following medications relax muscles in the prostate, which relieve urine out of flow tension. These drugs work better on small glands, and you can usually see an effect in 24-48 hours. All of the medications listed below will decrease blood pressure, except Flomax.

Hytrin
Cardura
Uroxatral
Flomax

The following medications work much better on prostates 40 grams or larger in size. They take 3 weeks to 2 months to work.

Proscar
Avodart

Office Procedures

The following procedures are minimally invasive and is performed under conscious sedation by a Certified Registered Nurse Anesthetist (CRNA).

Transurethral Needle Ablation (TUNA) works best for prostate glands under 40 grams in size and prostate length under 4 cm. The treatment lasts 30-45 minutes and a catheter is used for 2 days after the procedure. Typically when a TUNA fails it is because the median lobe did not shrink with the treatment. It is for this reason I always resect this lobe( mimi TURP) after doing the TUNA procedure on the lateral lobes. This allows patients to void much better as soon as the catheter is removed.

Transurethral Resection of the Prostate (TURP) is recommended only if a minimally invasive procedure has failed or the patient has a compromised bladder with poor function. Catheter use for 2-4 days after the procedure. This procedure is performed in the hospital.