BPH: When Prostate Begins to hurt

Benign prostatic hyperplasia (BPH)

is common as men get older—about half of men over age 60 experience it, and 90% of men age 80 or over have BPH symptoms. When symptoms for BPH worsen, such as urinating more often at night or experiencing a complete blockage of urine, surgery becomes an option.

The gold standard surgical treatment for BPH traditionally has been transurethral resection of the prostate (TURP). During TURP, the section of the prostate that blocks urine flow is removed. Although effective, TURP has its side effects. The procedure is limited to prostates of about 100 grams in size; erectile dysfunction also is possible.

For prostates larger than 100 grams, the other common option is an open prostatectomy, which involves opening the bladder and enucleating the BPH tissue. However, these patients often need a catheter for up to 5 days, and there’s more bleeding as well as a longer recovery period.

For men with an enlarged prostate, the holmium laser enucleation of the prostate (HoLEP) is a minimally invasive treatment option now available at University Hospitals Cleveland Medical Center. In this procedure, a holmium laser is used to separate the prostate gland tissue from the prostate capsule, which allows for complete resection of the benign tissue.

With HoLEP, you go through the urethra without an incision. Performing HoLEP is technically demanding, which has limited the number of surgeons who perform the procedure.