Providing Comprehensive Care for Benign Prostatic Hyperplasia
Providing Comprehensive Care for Benign Prostatic Hyperplasia
At UW Medicine, the Department of Urology is on a mission to improve the quality of life of individuals with prostate disease.
Urologist Brian Jordan, MD, treats a range of patients experiencing benign prostatic hyperplasia (BPH). BPH affects 70-80% of men as they age, and patients seek UW Medicine’s services for their symptoms – weak stream, frequency, urgency, retention, etc.
“When I’m able to treat these men, such as those with catheter-dependent urinary retention, they are my happiest patients by far,” says Jordan. “They go from being completely miserable to feeling normal again.”
But complexities can develop quickly for some of his patients who arrive with other complex cardiovascular, neurological or kidney issues. Jordan is adept at teaming up with experts across our specialties to tackle these most complex cases.
A growing BPH practice
While not all men with BPH require treatment, many choose to start with medications to manage their symptoms. Advances in medical therapy have allowed more patients to avoid or postpone surgery into their late 70s or 80s. When patients fail medical therapy, Jordan says surgery is the next step.
He is careful to counsel patients about which treatments might work best for their specific condition.
“Addressing lower urinary tract dysfunction is not a one-size-fits-all endeavor. I try to guide my patients toward the best options for them,” he says. “My goal is to match patients to the right procedure, making sure we look at their symptoms, priorities, expectations and recovery. Prostate size and anatomy are also important considerations.”
Less invasive BPH treatments
Urology has always been a field that has pushed for new techniques, surgeries and technologies. This is particularly true for BPH. The transurethral resection of the prostate (TURP) has long been considered the gold standard for many patients, but there are certain drawbacks and it is not right for everyone. Jordan offers a variety of minimally invasive procedures.
- Rezūm water vapor therapy
During this minimally invasive procedure designed to shrink the prostate, urologists pass a special cystoscope through the urethra to the prostate. They use a needle to inject small amounts of sterile water vapor. Each injection lasts nine seconds, so the entire procedure can be completed quickly. There is some initial swelling that requires a short catheterization, and over four weeks the body resorbs the prostate tissue treated with the steam. There is excellent preservation of sexual function with this option.
- GreenLight photoselective vaporization of the prostate
This TURP alternative uses a specialized laser to vaporize obstructing prostate tissue. This has superior hemostasis, allowing for routine, same-day surgeries and less bleeding both during and after surgery. This is particularly useful for patients on anticoagulation.
- Robotic simple prostatectomy
For very large prostates, the options are more limited. The simple prostatectomy affords excellent outcomes, but the older open approach has significant blood loss and a long recovery. Transitioning to a robotic approach has resulted in a significant reduction in blood loss, only a one- or two-night hospitalization and a faster recovery.
The team utilizes additional diagnostics like video urodynamics to evaluate complex voiding dysfunction. Many men with enlarged prostates may also be concerned about prostate cancer or have an elevated PSA. We routinely utilize prostate MRI, and with the help of our experienced radiologists, the MRI helps us identify possible prostate cancer and provides useful information for surgical planning.
Jordan reflects: “At UW Medicine, we have the advanced treatments needed to care for patients with complicated problems. We don’t pass the buck. We work with our patients to find a reasonable treatment that’s right for them.”
