Spending too much time in the men's room?

Author: Dr. Murphy

You're probably heard the ads on TV —  Trouble going?  Always in the bathroom?  Take this medication and stop being bothered by your aging prostate!

Prostate enlargement, called "Benign Prostatic Hyperplasia," or BPH for short, affects a lot of us — up to a third of all men will be bothered by it at some point. As the prostate enlarges, it pinches off the flow of urine from the bladder. Slowing of the stream, difficulty starting, and poor bladder emptying are the most common signs. A strong urge to go right away, even leaking before making it to the bathroom can happen, as well as getting up more often at night. We're not really sure why some men get it and others don't. It isn't caused by the things we eat or drink, or anything we do — you could say it's just part of aging, like arthritis or getting cataracts.

Fortunately there are ways to treat it. Some men feel that herbal remedies such as saw palmetto help them (although medical studies that compared saw palmetto to a sugar pill do not seem to show much benefit).  There are a couple of different types of prescription meds that work well:  

• Flomax, now available as the generic drug Tamsulosin, is the most commonly used medication for BPH. It relaxes the muscle fibers where the bladder empties through the prostate to open up the urinary flow. This medication starts working in just a week or two.
• Avodart, and a similar generic called Finasteride, shrink the prostate to improve the urinary stream, although it can take a few months to notice any improvement.  

Side effects of both of these meds are usually temporary and aren't too bothersome.

For some men, medications don't help enough. They might need a procedure to open up the urinary channel. These treatments are done under a sedative or fully asleep so there isn't any pain:

• Microwave Hyperthermia heats the prostate tissue up, and over the next few weeks it shrinks to open the channel.
• Another type of treatment removes the enlarged prostate tissue through a scope in the urethral channel. Some people call this a "Roto-Rooter."  In one technique, a laser uses a beam of energy to vaporize the tissue. The other, called Transurethral Resection, or TURP, trims out the tissue. Most men are back to full activities within a week or two. 

So all those ads on TV do make a good point. Prostate enlargement can be really annoying, and there are lots of ways to treat it. Like they say, talk to your doctor and see what you can do to urinate normally again.