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BPH


Our researchers are actively involved in
projects to discover new BPH therapies


When the prostate grows too large, the flow of urine can be slowed or stopped, leading to a medical condition called benign prostatic hyperplasia, or BPH.
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 options.

BPH, 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.