Enlarged Prostate (Benign Prostatic Enlargement or BPH)

What is a prostate?

The prostate is a walnut-sized gland located just below the bladder.  It surrounds the urethra, which is the tube that carries urine out of the body.  The prostate's main function is to produce fluids which help transport sperm.

Why is my prostate enlarged?

The prostate gland has one growth period in adolescence and another beginning around age 45 that continues for the rest of a man's life.  This second growth phase often results in benign prostatic hyperplasia (BPH), one of the most common health problems in men over 50.  BPH eventually affects 80% of all men.

What is BPH?

Benign Prostatic Hyperplasia is the medical term for an enlarged prostate.  BPH is not cancer and it does not cause cancer.  It does, however, make urination more difficult.  Symptoms may include an urge to urinate frequently, disrupted sleep due to nighttime urination, a weak or interrupted stream, pain when urinating, or the sensation of incomplete bladder emptying.

How does BPH affect urination?

Prostate enlargement usually starts at the innermost part of the prostate, the area closest to the urethra.  As the prostate expands, the growing tissue gradually compresses the urethra like a clamp on a garden hose.  Urination becomes more difficult and the bladder may not be able to empty completely.  This can irritate the bladder and, if left untreated, can lead to much more serious problems.

What are my options?

You don't have to endure the symptoms of BPH.  Prostate enlargement is treatable.  Your options range from medication to outpatient procedures to traditional surgery.

Is one treatment better than another?

Each treatment has advantages and disadvantages, and all medical procedures have potential risks and complications.  You should talk to your doctor about all of your options.

Medication is usually the first treatment for BPH.  There are several medicines that relieve the symptoms in most men, at least initially.  For some, medication loses its effectiveness over time or causes undesirable side effects such as dizziness, low blood pressure or impotence.  And, because BPH symptoms return when the medication is stopped, even those who find continued relief without side effects are faced with the lifelong expense and inconvenience of a daily medication regimen.  Thus, many seek longer-lasting solutions.

The most traditional long-term treatment is surgery, which cuts away the enlarged prostate tissue.  Transurethral Resection of the Prostate (TURP) is the most common BPH surgery.  It involves inserting an instrument in the urethra and removing excess prostate tissue one piece at a time.  Another surgical option, open prostatectomy, requires an abdominal incision and is therefore typically reserved for severely enlarged prostates. 

These traditional surgeries generally require one –to- three day hospital stays.  Both surgeries can provide long-term relief, but they can also produce serious long-term side effects such as incontinence, difficulty attaining erections and ejaculation problems.

In an effort to deliver long-term relief with fewer risks and side effects than traditional surgery, medical scientists have developed and refined other BPH treatments in recent decades.  These treatments use advanced technology, such as lasers, microwaves, or radio frequency to reduce the size of the prostate without actually cutting it.  These less invasive outpatient procedures are frequently recommended as alternatives to medication or when medication fails.  They usually cannot be performed if BPH has progressed to a severe stage and are not generally recommended for patients with poor bladder function.

Among these modern options, one of the most advanced is the Indigo LaserOptic Treatment System, from Indigo Medical, Inc., a Johnson & Johnson company.

How does the Indigo LaserOptic Treatment System work?

Your urologist threads a special Indigo fiber through the urethra and into the prostate, positioning the tip of the fiber in the targeted treatment area.  The fiberoptic tip delivers controlled laser energy that coagulates, or destroys, very precise areas of the prostate.  No incision or cutting of tissue is involved.

The treatment is typically an outpatient procedure conducted in thirty minutes or less with a variety of anesthesia options available, including general, spinal and local.  Choice of anesthesia will vary depending on the patient and the size of the prostate.  Patients must us a catheter until the swelling subsides, although this should not restrict activity.  The catheter is usually removed within a week.

As the body gradually absorbs the coagulated tissue, the prostate becomes smaller, the urethra returns to its normal shape and size, and urine flows more freely again.  Patients generally begin to feel relief from BPH symptoms within weeks and continue to improve over a period of several months.

Why should I consider the Indigo LaserOptic Treatment System?

There are several significant advantages over other treatment options.  The Indigo LaserOptic Treatment System:

• Actually reduces the size of the growing prostate instead of simply treating symptoms as most medications do.
• Usually eliminated the need for BPH medications and the related expense, inconvenience, possible side effects and potential interactions with other medications.
• Has been shown to have a much lower incidence of serious long-term side effects, such as incontinence and ejaculation problems, than TURP and other traditional surgeries.
• Is more precise and controllable than microwave and other heat therapies, which can mean fewer complications and less damage to surrounding tissue.
• Is also generally a viable treatment option for patients with metal implants in the hip and pelvic region, cardiac pacemakers or defibrillators.  These patients may not be eligible for microwave or radio-frequency therapies.

Are there any disadvantages versus other treatments?

Unlike medication therapy, laser treatments are administered in a hospital or outpatient surgery center and require some for of anesthesia.

During the first few days or week of recovery, a laser treatment patient may be somewhat less comfortable and experience less short-term symptom relief than a man who has a TURP.  This is because the coagulated, or destroyed, tissue disappears gradually and, consequently, the swelling may subside more slowly than it does when tissue is cut out.  Over the longer term, however, studies have shown that urine flow improvements are significant with the Indigo LaserOptic Treatment System.

Is the Indigo LaserOptic Treatment system covered by my insurance?

Most major insurers cover the Indigo LaserOptic Treatment System, including Medicare and Medicaid.  Check with your provider before selecting the procedure to be sure of your coverage.

How can I learn more?

Your doctor can answer many of your questions regarding BPH and the various treatments.  If you'd like more information about the Indigo LaserOptic Treatment System, call 1-800-861-5370 or visit the web site at http://www.indigomedical.com.