Prostate Problems

What is the prostate?

A healthy prostate is about the same size as a walnut. Located below the bladder, the prostate surrounds the urethra, the tube that carries urine from the bladder out the penis. The prostate’s main job is to help in the creation of semen, the fluid that helps protect the sperm when a man ejaculates.

Enlarged prostate or benign prostatic hyperplasia (BPH)

Prostate enlargement is common as men age. Because of the prostate’s location, some men may have lower urinary tract symptoms (LUTS) when the prostate is enlarged. Enlarged Prostate affects at least half of men over age 50. LUTS caused by enlarged prostates can be a problem for some men as they age.

Enlarged prostate symptoms may include:

  • frequent urge to urinate
  • getting up to urinate two or more times a night
  • difficulty emptying your bladder
  • having a weak urine stream that may start and stop
  • having trouble starting to urinate
  • only urinating a little bit each time you go to the bathroom
  • leaking or dribbling urine after going to the bathroom
  • feeling like you still have to urinate, even after you’ve gone to the bathroom
  • feeling a strong, sudden urge to urinate
How would I know if I have an enlarged prostate?

The AUA recommends men over the age of 40 should have regular prostate exams. Your doctor can perform a digital rectal exam (DRE), a prostate specific antigen (PSA) blood test, and evaluate any urinary symptoms you may have. Other urological conditions may lead to similar symptoms. Many men with an enlarged prostate don’t have any signs or symptoms. Your doctor can tell if you have an enlarged prostate.

What causes an enlarged prostate?

Experts are still learning what causes an enlarged prostate. Scientists have found that the hormone dihydrotestosterone (DHT) may be the number one cause of enlarged prostate. Men who have close relatives with an enlarged prostate are more likely to have it. Obesity may also raise your risk. Aging is one of the biggest risk factors for enlarged prostate.

Can an enlarged prostate or BPH get worse?

The prostate can continue to grow over time. In some men, urinary symptoms may develop and become worse. Enlarged prostate can lead to bladder damage, infection and even kidney damage. In serious cases, the prostate may get so enlarged that urine flow is completely blocked. This condition is known as acute urinary retention (AUR) which needs emergency treatment.

What are the side effects from treatment for an enlarged prostate?

Talk with your doctor about the treatment that might work best for you. What your doctor suggests will partly depend on your symptoms and the size of your prostate. Regular visits to your doctor are important if you have an enlarged prostate. Your doctor needs to know about any changes in your symptoms. If you’re taking medicine,
he or she will want to know how it’s working. If your symptoms get worse, you may need to try a different treatment.

Tell your doctor about any:

  • changes in your symptoms
  • side effects from medicines
  • sexual problems, like low sex drive or trouble having an erection
Alternative Medicine

You may have heard about some herbal or alternative medicines used for an enlarged prostate. There is no convincing evidence that these agents help prostate problems. Always check with your doctor before using an alternative treatment. Some herbs, minerals and other supplements can interact with drugs or foods. They can also cause side effects. Just because something is natural does not mean it is safe.

Treatment Options

There are several options to treat men with bothersome urinary symptoms and enlarged prostates. To find out if one of the many types of treatments is good for your prostate condition, talk to your health care provider.

  • Watchful waiting – If your urinary symptoms are not bothering you that much, you and your doctor may choose “watchful waiting,” which involves regular exams to check your prostate.
  • Medicines – There are two types of prescription drugs treat the symptoms of enlarged prostates: the 5-alpha reductase inhibitor (5ARI) medicine helps shrink the prostate, and the alpha blocker drugs relax the muscle of the bladder and prostate muscles to improve urine flow and reduce uncomfortable symptoms.
  • Minimally Invasive Treatments – These treatments include the use of lasers (holmium laser enucleation or photo vaporization) and heat treatments (transurethral microwave therapy and transurethethral needle ablation) which help eliminate the prostate tissue that is blocking the urethra.
  • Surgery – For some men with enlarged prostates, surgery may help with bothersome symptoms. Surgery may include a transuretheral resection or TURP (the prostate’s inner core is removed), a transurethral incision or TUIP (to reduce pressure on the urethra) or a prostatectomy (to actually remove the prostate).
Treatment with Rezūm

Powered by convective water vapor energy, the Rezūm System delivers targeted, controlled doses of the stored thermal energy in water vapor directly to the region of the prostate gland with the obstructive tissue causing the lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).

Each 9-second treatment uses 0.42ml of heated sterile water vapor which rapidly and uniformly disperses through the tissue interstices. The condensation of water vapor releases stored thermal energy. Cell membranes are denatured, thereby causing immediate cell death, the vasculature is closed, and there is denervation of the alpha-adrenergic nerves within the treatment zone providing you with an efficient, uniform, predictable treatment.

Over time, this ablated tissue is reabsorbed by the body’s natural healing response, reducing the volume of tissue allowing the urethra to open relieving LUTS.

The Rezūm procedure provides the following benefits to men suffering from BPH:
  • Alternative to BPH medications1
  • Studies support Rezūm relieves symptoms safely and effectively2
  • Noticeable symptom improvement within two weeks2
  • Simple in-office/out-patient therapy2
  • Does not require general anesthesia2
  • Preserves erectile and urinary functions2
  • Ability to return to regular activities within a few days2*
  • Covered by Medicare and most private insurers3**

1. McVary KT, Rogers T, Roehrborn CG. Rezūm water vapor thermal therapy for lower urinary tract symptoms associated with benign prostatic hyperplasia: 4-year results from randomized controlled study. Urology Gold Journal. 2019 Jan 23. [Epub ahead of print]
2. McVary KT, Gange SN, Gittelman MC, et al. Minimally invasive prostate convective water vapor energy (WAVE) ablation: A multicenter, randomized, controlled study for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2016; 195: 1529.
3. Data on file with Boston Scientific.

*Dependent on individual clinical situation and healing response.
**Boston Scientific does not guarantee insurance coverage for any procedure or product. It is the responsibility of the patient to contact their insurance provider for specific coverage information.

The Rezūm System is intended to relieve symptoms, obstructions, and reduce prostate tissue associated with BPH. It is indicated for men ≥ 50 years of age with a prostate volume 30cm3 ≤ 80cm3. The Rezūm System is also indicated for treatment of prostate with hyperplasia of the central zone and/or a median lobe.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.

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