Live Well Dayton: Urology

 Live Well Dayton: Urology

Dayton Physicians urologist offers new, less invasive prostate procedure

By Beth Langefels

It is estimated that more than half of men over the age of 60 are living with an enlarged prostate. Also called benign prostatic hyperplasia (BPH), this condition can cause uncomfortable symptoms, especially a more frequent urge to urinate and difficulty urinating.

The prostate goes through two main growth periods. The first happens early in puberty when the prostate doubles in size. The second phase begins around age 25 and continues during most of a man’s life.

As the prostate enlarges it can then squeeze down on the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and the inability to empty the bladder completely cause many of the problems associated with BPH. The condition does not cause nor lead to cancer. But BPH and cancer can happen at the same time.

In addition to medication, surgery is sometimes performed to give men relief from this condition. According to Dr. Michael Yu, a urologist with Dayton Physicians Network, prostate surgery has traditionally meant a longer recovery—sometimes as much as six to eight weeks before a patient is back on his feet.

“The gold standard has always been transurethral resection of the prostate (TURP),” Yu says. “We go in with an electrical surgery loop and scrape the prostate, removing tissue.”

Yu says the longer recovery time includes a month of very limited activity, which can take longer if the patient is diabetic. The procedure also comes with potential post-surgery complications that may cause many men to avoid it altogether. These include temporary difficulty urinating, recurring urinary tract infections, erectile dysfunction and incontinence. Many of these complications occur due to the catheter inserted during surgery.

But an alternative procedure is now offered to men suffering from BPH that has fewer risks and complications and can help men return to their normal lives relatively quickly.

“I’ve been doing the UroLift procedure for just over three years,” says Yu. “I was the first in Dayton to do this procedure, which is minimally invasive and takes only about 10 minutes to perform.”

The UroLift procedure uses tiny implants to lift and hold the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue. And Yu says he’s performed about 150 of these procedures, which have comparable results as the traditional prostate surgery.

“For most men recovery is only a few days and they are back to normal,” Yu says. “And it’s durable from five to six years or even more in some cases.”

A successful prostate surgery means no more medication and with UroLift virtually no downtime. Yu says most men report they are doing “fine” with medication, but they are still losing sleep—walking up several times per night to use the bathroom.

“If you ask their spouses they would say they are definitely not doing fine,” Yu says. “Some men who aren’t even very enlarged are getting up six to seven times per night.”

BPH is the most common reason men visit a urologist and, according to Yu, many men may not notice symptoms until they disrupt their lives. 

“Most men diagnosed with BPH could be doing better,” Yu says. “The issue is a lot of them hear the word ‘surgery’ and they think they aren’t bothered enough to go through that.”

The goal of the UroLift procedure is to help men get relief from their urinary symptoms and get back to a normal life as quickly as possible. And Yu says this 10-minute procedure does just that.

“We run some tests to make sure a patient will do well,” Yu says. “We encourage men to come in sooner rather than later because if they wait too long the bladder muscle may not fully recover.”

In fact, if left untreated BPH can lead to permanent bladder damage. And when the bladder does not empty completely the risk of developing urinary tract infections (UTIs) increases. Other serious problems can also develop over time as well, including bladder stones, blood in the urine, incontinence or urinary retention.

Yu has an overall success rate of 97 percent. A small percentage of men will require traditional surgery if UroLift fails for them. And the durability of the procedure is at least two to six years, but the implants, which are designed to be permanent, could last longer.

“We have data that runs out to about five to six years,” Yu says. “We have European data that shows that’s it’s still durable from 10 to 15 years, however.”

Any man aged 45 or older who is experiencing symptoms of BPH is a candidate for the UroLift procedure. Other symptoms may include difficulty starting a urine stream, feeling a need to push or strain, dribbling, inability to empty the bladder completely, a weak urine flow and burning or pain during urination.

“The most common thing I hear from patients is that they wish they would have come in sooner,” Yu says. “Anybody who is doing OK but thinks they want to do better should give us a call, so we can go over options.”