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In early 2021, Scott Bridges was staying with his son in Sandy, Utah, when he awakened one morning unable to urinate. Over 16 frustrating hours, the 64-year-old kept returning to the bathroom without being able to pass any urine.
Throughout the day, his situation only became more painful—until he decided to go to a nearby urgent care. A nurse inserted a catheter and drained over a liter from his bladder.
"I had this attack with my prostate, and it just shut me down," Scott recalls. "It stopped me in my tracks."
The next day, Scott traveled to Washington State, only to again find he could not urinate. After he went to a local ER, he ended up wearing a catheter for six weeks.
On his return to Utah, Scott saw a provider at University of Utah Health's Department of Urology. The urologist explained that Scott had benign prostate hyperplasia (BPH), a non-cancerous condition where the prostate becomes enlarged. A man's normal prostate weighs 20 grams; Scott's weighed 130 grams.
When the prostate swells, it often slows a man's urine flow. Sometimes, in just a matter of hours, it swells so badly that a man cannot urinate at all.
The prostate's primary role is in reproduction, "making some of the fluid in the semen," says Kelli Gross, MD, a urologist specializing in male infertility and men's health at University of Utah Health.
An enlarged prostate is a condition that typically impacts men over the age of 40, Gross says. "The prostate tends to enlarge with age, which can sometimes lead to urinary symptoms. It can slow the flow of urine, or men can have a hard time getting started urinating."
After testing, Scott learned his prostate was about six times the size of a normal prostate. Scott called a friend of his who had similar prostate issues several years ago. This friend had a minimally invasive procedure known as the HoLEP Procedure–Holmium Laser Enucleation of the Prostate. He hasn't had any prostate problems since the procedure.
Gross is the only provider in Utah who performs HoLEP. When Scott went to see her, she explained what the procedure involved. She passes a scope with a laser and camera through the penis into the prostate gland, using the laser to remove the majority of the pulpy tissue at the center of the prostate while keeping the outside rim of the organ itself intact.
Gross' mentor described the procedure, she recalls, "as like peeling an orange from the inside." Using the laser, she removes all of the excess prostate tissue, pushing it into the bladder and using a special device to break up and remove the prostate tissue.
In Scott's case, Gross removed 85% of his prostate during a two-hour-long procedure. Post-surgery, he went home with a catheter. The next day, Gross' staff removed it. Scott's been catheter-free ever since, he says.
Gross warned him that there was some potential for incontinence and blood in his urine, along with soreness in his genitals, for several months after the surgery. But after just two weeks, the only issue Scott experienced—blood in his urine—had stopped.
"The risk of long-term incontinence is very low," Gross says—just 1-2% of patients. Gross explains what can happen post-procedure, though. During sexual intercourse, "a man's ejaculate doesn't necessarily go forward, or come out," she says. "For most people, it's not going to have a huge effect unless they are worried about reproduction."
Scott remains thrilled with the procedure and the comforting professionalism of Gross and her staff. "A few months after my surgery, my bladder empties every time I urinate and I sleep six hours through the night," he says. As for sexual function post-operation, he's "happy to report all aspects of my body's function in marital relations is exactly as it should be."
Scott stresses that this is "a serious health problem for men over 40," he says. "And especially those 60 and older."
Given the role the urinary tract plays in draining toxins that may build up in our bodies, the HoLEP Procedure could be "a lifesaver in severe cases," he says. "It certainly will add years of comfort and better health to your life if you are suffering from BPH-related symptoms."
