Prostate Problems

Prostate Problems, Enlarged Prostate

A simple prostate exam could save your life.

All men over 50 are at risk for prostate problems, and should be screened every year. Signs of a potential prostate problem include:

  • Painful, weak, or lack of urination
  • Urination that wakes you at night
  • Having to urinate often
  • Low back pain or "achiness" in the pelvis

Dr. Kaufman uses advanced testing methods to detect prostate problems. Early detection can allow for simple treatment with oral medication, or other simple outpatient procedures.

Radio Interview - Microwave Therapy for Enlarged Prostate

In January 2005, Dr. Kaufman was interviewed for American Health Radio for a program on minimally-invasive, microwave treatment for enlarged prostate (BPH).

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What is the Prostate?

The prostate is a muscular, walnut-shaped gland, which is responsible for manufacturing part of the fluid that makes up semen, the solution that transports sperm. Situated right below the bladder, the prostate surrounds the urethra, which is the tube that transports urine from the bladder out of the body.

What is BPH (benign prostatic hypertrophy)?

As a man ages, his prostate naturally enlarges. As it increases in size, it eventually encroaches upon the urethra, causing partial and sometimes complete obstruction of urine flow. This condition is known as BPH. BPH is a benign (non-cancerous) enlargement of the prostate.

Normal Prostate and Enlarged Prostate

While it is rarely life threatening, it can be inconvenient, uncomfortable and negatively affect your quality of life. Typical symptoms of BPH include the following:

  1. Weak urine flow
  2. Sudden urge to urinate
  3. Difficulty/discomfort initiating urination
  4. Frequent trips to the toilet at night and during the day
  5. Sensation of incomplete bladder emptying
  6. Stopping and starting of the urine flow

If you are suffering from the symptoms of BPH, you are not alone. In this country, approximately half of all men over the age of 50 have some or all of these symptoms. By age 80, this number has jumped to 80% of all men.

In order to determine how much your particular urinary problems are bothering you, Dr. Kaufman will ask you to complete a questionnaire called the AUA Prostate Symptom Score to evaluate your symptoms. Your total score on this questionnaire will help us evaluate the severity of your condition. In addition, a complete physical exam will be performed as well as tests which measure urine flow rate and the amount of urine left in your bladder after urination. These tests will allow us to better understand your particular condition and help us determine the best treatment for you.

What are my treatment options?

Several options are available to you for treatment of your prostate condition. Surgery is a proven and effective approach, but requires hospitalization and can involve many significant side effects. Drug therapy is chosen by many men, but requires a life long commitment and can sometimes be associated with undesirable side effects. You may have heard of new, minimally invasive procedures for prostate enlargement that use a variety of new technologies and techniques. These procedures have been developed in an effort to find new treatments that reduce the risk of side effects, minimize cost and recovery time, and enhance patient comfort, while providing excellent clinical results. Two of these minimally invasive treatment methods are described below:

TUMT: transurethral microwave thermotherapy

Safe and effective. Clinical studies have shown that microwave technology provides a safe and effective treatment for BPH. Application of heat or thermotherapy to the prostate gland by use of microwave causes changes in the prostate tissue, thereby "shrinking the prostate" or enlarging the urinary channel through the prostate (urethra), thereby providing symptom relief to the patient. The TUMT procedure using the newest generation of microwave thermotherapy devices, the TherMatrx, can be performed in just one hour, under only local anesthesia in our office with minimal discomfort. You are completely conscious during the procedure and will walk out of the office as soon as you're done. The vast majority of patients experience absolutely no side effects, sexual or otherwise, from this procedure.

Procedure description. The patient is provided with an oral antibiotic pill, a mild pain reliever pill, and a muscle relaxant pill to be taken an hour prior to the procedure. A local anesthetic jelly is instilled into the urethra just before the procedure is to start. Dr. Kaufman will then pass a small, flexible catheter through the urethra into the bladder. This catheter contains a special microwave antenna that delivers heat only to the prostate gland. The antenna is connected to the microwave generator of the TherMatrix. Microwave energy is then delivered to the prostate gland for the treatment period of approximately one hour. Patients often spend this time listening to music through their personal headsets or reading a good book.

After the treatment, the patient is sent home with a small catheter placed into the bladder through the urethra, which will drain urine from the bladder into a small bag, strapped to the upper leg for a period of 3-5 days. During this time, the patient should refrain from vigorous activities, but may return to work and limited activities the next day. After the catheter is removed, you are free to resume your normal everyday activities. A period of 6-8 weeks is required for complete healing of the prostate and any noticeable improvement of your BPH symptoms. You will meet with Dr. Kaufman periodically to review and discuss your progress.

TULP: interstitial laser coagulation

The indigo diode laser system is another new and widely used minimally invasive therapy used by Dr. Kaufman for the treatment of BPH. Here too, the prostate gland is quickly heated, this time using laser energy to destroy (coagulate) the obstructing prostate tissue. This procedure is most often performed in the hospital operating room with the patient fully anesthetized using spinal or general anesthesia. The indigo laser fiber is passed through a cystoscope (small telescope placed into the urethra to visualize the prostate gland and bladder) and placed directly in contact with the prostate tissue under direct vision. Like the microwave procedure, the destroyed prostate tissue is absorbed naturally by the body, with a resulting improvement of the patients voiding symptoms over a period of 6-8 weeks. A catheter is required for 3-5 days after this procedure as well. More details about the indigo laser system are available on the manufacturer's website.