Benign prostatic hyperplasia or BPH is medical jargon for an enlarged prostate and the symptoms that accompany this diagnosis. As men increase in age, they can have an increase in the amount of prostate tissue and in the tone or rigidity of the tissue. These changes may result in urinary symptoms that decrease quality of life.

Unfortunately, one study has shown that up to 90 percent of men between the ages of 45 and 80 years old will suffer some type of urinary dysfunction — and many of these are because of prostate enlargement.

The exact reason behind this enlargement is unknown, but there is a genetic component or predisposition. It is important to note that these symptoms are very rarely caused by prostate cancer, but it is important to be evaluated.

Below, Drs. Bradford Stevenson and Robert Wayment, urologists at Ogden Clinic, shed some light on BPH.

What are the symptoms of BPH?

Initial symptoms of an enlarged prostate are from blockage and include slow stream, intermittent flow, straining to void and incomplete bladder emptying. The bladder is a muscle and as it is required to push harder to expel the urine, it becomes stronger. A stronger and thicker bladder does not store urine as well and this results in increased urinary frequency and urgency (with potential leakage) and waking up at night. All of these symptoms have the potential to negatively impact a man's quality of life. These can limit him socially.

What treatments are available?

Treatments available for an enlarged prostate and its associated symptoms include both medical and surgical therapy. Medications are available that either relax or shrink the prostate to improve symptoms. Unfortunately, these almost always require lifelong administration and can lose efficacy over time as the prostate disease continues to progress.

Multiple surgical therapies are available and vary in both efficacy and invasiveness. The gold standard is transurethral resection of the prostate (TURP), which is surgical removal of the excess prostate tissue through a scope. This treatment is very effective but is somewhat invasive with a prolonged recovery. There have been multiple variations on this theme with different energy sources and approaches. Some treatments focus on decreasing the invasiveness (by shrinking or displacing tissue) but lose efficacy by doing so.

Rezum: a new approach

Rezum is a new approach to the treatment of prostate enlargement that has been able to maintain efficacy by still destroying tissue, but does so in a minimally invasive manner. During an in-office procedure with a local numbing medication, steam is injected into the prostate to destroy the overgrown tissue. This is accomplished in a matter of minutes as opposed to outpatient surgical procedures, like TURP, that can take an hour or more. The steam breaks down the overgrown prostate tissue which is then reabsorbed by the body. Although results can vary, most men experience an improvement in symptoms as early as two weeks after the procedure.

Recovery from Rezum takes significantly less time than with standard prostate surgery. In most cases, you will go home with a catheter overnight to help with bladder drainage and have it removed the next day. There can be some blood in the urine after the procedure and some mild burning or pain with urination. This is usually mild and can be treated with over the counter pain medication such as Tylenol. Most patients return to their regular activities within a few days. Studies have shown that Rezum has no negative impact on sexual function and there have been no cases of incontinence after the procedure.

In conclusion

BPH is a common problem in men with bothersome urinary symptoms, but one that can be treated successfully. There are options for men who suffer from this problem including medication or surgery. For those who don’t like the idea of taking long term medications or don’t want to undergo an invasive procedure, Rezum provides a minimally invasive, in-office procedure with a short recovery and long-term results.

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