BPH: Weighing surgical options

Ever wondered why older men seem to need to urinate frequently? An enlarged prostate gland is likely to blame. The condition, benign prostatic hyperplasia, or BPH, is so common that it affects 90% of men by age 80.

The prostate gland is roughly donut shaped and is located below the bladder. The urethra, the “tube” that carries urine out from the bladder, passes through the prostate. As the prostate enlarges (swells), it squeezes the urethra, making it difficult for urine to flow through.

Symptoms of BPH include

  • increased frequency and urgency of urination
  • weak urine flow
  • leakage, or inability to control urination

While BPH is not dangerous, it can have a powerful impact on quality of life. Affected men feel they cannot stray far from a bathroom. And they worry about the embarrassment of an accident. BPH also causes frequent nighttime urination, which can bring on insomnia, fatigue, and depression.

Although medication and lifestyle changes can be effective, if symptoms become too imposing, the doctor will probably suggest surgery. There are many different types. Review these questions with the doctor as you help your loved one evaluate the options:

  • What kind of improvement can be expected? How soon after the procedure will symptoms be relieved?
  • How long will the benefits last? What is the likelihood of needing retreatment in five years?
  • What is the recuperation like? Pain? Bleeding? Swelling?
  • What are the risks or complications? How likely are they to happen?
  • Can this procedure occur on an outpatient basis, or will hospitalization be required?

There is no one surgery that fits all. And new approaches are being developed all the time. The goal is to find the surgery that brings the greatest relief for the longest period of time with the lowest likelihood of complications.