•When the prostate grows too
large, the flow of urine can be slowed or stopped, leading
to a medical condition called benign prostatic hyperplasia,
• Throughout a man's life, the
prostate grows in size, reaching the size of a golf ball by
his early 50s, and growing even larger by age 70.
• When left untreated, BPH can
worsen over time in some men and lead to more serious health
problems, including urinary tract infections, urinary retention,
bladder stones, or kidney damage.
• BPH can be treated effectively
with medication or a variety of minimally invasive surgical
a noncancerous enlargement of the prostate gland, is the most common
benign tumor found in men. This prostatic growth, a normal part
of the aging process, causes the prostate to compress the urethra,
making urination difficult, painful, or both. In addition, it can
cause the muscles at the top of the urethra to squeeze down, making
it difficult for the urethra to allow the passage of urine. The
result is that the bladder does not completely empty following urination,
thereby increasing the number of times one has to urinate during
the course of the day and night.
Johns Hopkins urologists treat BPH with drug
therapies (a combination of alpha blockers and 5-alpha-reductase
inhibitors) to relax smooth muscles in the prostate; surgery to
reduce the size of the gland; and various minimally invasive heat
therapies to destroy tissue and reduce the pressure on the urethra.
Surgical options include TURP (transurethral resection
of the prostate), the time-tested standard, as well as the newer
minimally invasive thermal treatments (TUNA and TUMT), which provide
excellent outcomes and proven durability. The newest of these is
PVP, or Photoselective Vaporization of the Prostate. With PVP, a
special high-energy laser is inserted into the urethra and used
to vaporize excess prostate tissue, coagulating and sealing the
treated regions immediately. The
powerful green light energy source, which effectively vaporizes
and removes enlarged prostate tissue, has helped make this a very
effective and popular BPH procedure.
Since PVP is generally an outpatient procedure,
the patient can go home the same day, although some men may have
to use a catheter for a day. Last year, many of these PVP procedures
were performed, and the number will increase significantly in the
years to come.
Brady Urological Institute urologists are actively
involved in ongoing research projects to discover new minimally
invasive treatments and therapies. David Y.S. Chan, M.D., the Director
of Outpatient Urology, is currently investigating the genetics of
BPH, with the goal of developing new medications to help reverse
prostatic changes. In conjunction with Christian P. Pavlovich, M.D.,
the Director of Urological Oncology at Johns Hopkins Bayview Medical
Center, Dr. Chan continues the search for biomarkers for BPH as
well as prostate cancer.