Ziya Kirkali, MD, is Program Director of the Division of Kidney, Urologic, and Hematologic Diseases at the NIH's National Institute of Diabetes and Digestive and Kidney Diseases. He spoke to NIH MedlinePlus magazine about BPH.
Does the presence of BPH mean that a man is at a greater risk for prostate cancer?
As men age, the prevalence of both BPH and prostate cancer increase. For men in their 70s and 80s, both conditions are very common. But, there is no real evidence to show there is causation between BPH and prostate cancer.
Some men may be concerned that even minimally invasive procedures to ease the urinary problems of BPH will have sexual side effects.
BPH, in itself, may not cause a lot of sexual dysfunction. However, some medical or surgical treatments may impact sexual aspects of health. Some medications and surgical treatments used to treat BPH may cause erectile dysfunction (ED) or ejaculatory problems.
What are the differences between two of the most common treatments for BPH—TURP and TUIP? Between the two, is there a clear favorite among patients and doctors?
Transurethral resection of the prostate (TURP) is the classic standard treatment. We put a resectoscope inside the man's urethra. (See Treatments in accompanying story.) In TURP, we remove prostate tissue in small bits with the resectoscope and wash it out through the bladder. In the transurethral incision of the prostate (TUIP), there is an incision at the bladder neck. So, that really cuts the muscles there. Of course, we don't remove any tissue in TUIP. So, in terms of selection, most surgeons do a standard TURP. When the prostate is rather small, some urologists prefer TUIP.
In the past, TURP was a more invasive procedure. The most common complication after TURP is bleeding. It's a pretty safe operation these days. Technology is evolving, so bleeding rates and other complications are much lower than in the past.
What risks do men run if they ignore this problem?
Sometimes men ignore symptoms, thinking they are a normal part of aging. And they are. But, some patients who ignore symptoms may experience urinary retention—be unable to release their urine. In that case, they may need emergency care to have a catheter put into their bladder to release the urine.