An Overactive Bladder and Its Impact on Benign Prostatic Hypertrophy (BPH)

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As men age, their reproductive systems go through changes and may develop certain conditions and illnesses of that system, including those involving the prostate.

What Is the Prostate Gland?

The prostate is part of the male reproductive system, including the seminal vesicles and testicles. About walnut size, the prostate is located in the pelvis and sits just below the bladder. The prostate gland surrounds the urethra and produces the slightly alkaline prostatic fluid that combines with sperm and fluid from the seminal vesicles to form seminal fluid.

The prostate is vulnerable to some disorders of age and infection, including inflammation, a bacterial infection such as chronic bacterial prostatitis, prostate cancer, and benign enlargement of the prostate, also called Benign Prostatic Hyperplasia.

Benign Prostatic Hyperplasia

Benign Prostatic Hyperplasia or BPH is an enlarged prostate gland that is not cancerous. An enlarged prostate causes very uncomfortable urinary symptoms and may press against the urethra and block the urine flow through it from the bladder out. In extreme cases, it may cause problems for the bladder and the urinary tract and even the kidneys.

Another symptom associated with BPH is an overactive bladder. Overactive bladder is a condition in which you feel the need for frequent urination, or the need comes upon you urgently. For some people with overactive bladder, getting to the restroom in time may be difficult. You may also find it difficult to empty the bladder when you urinate, the feeling that you need to go lingering on.

BPH and overactive bladder have some overlapping symptoms, and because of that, a doctor could misdiagnose one as the other.

BPH Symptoms

Prostate enlargement will lead to worsening over time. The most common signs and symptoms of BPH include:

  • Frequent need to urinate, especially an urgent need (overactive bladder)
  • Need to urinate at night (nocturia)
  • Difficulty starting to urinate
  • A weak stream of urine
  • Urine flow that stops and starts
  • Dribbling
  • Urinary retention
  • Urine blood

Overactive Bladder and BPH

Overactive bladder, also known as Urge Incontinence, is a strong and urgent need to urinate, triggering the bladder to spasm and push out urine. It can lead to embarrassing situations, and many who suffer from an overactive bladder enjoy fewer social activities, fearing leaking or having to run to the bathroom. Nighttime urination may also be an issue requiring special protective underwear or bed linens in extreme cases.

There is no one cause of overactive bladder. Many illnesses and conditions can cause it, including bladder cancer, bladder inflammation, infection, bladder stones, nerve problems, and urethra and urine flow obstruction.

BPH and Increased Risk of Prostate Cancer

Overactive bladder and other symptoms connected to prostate problems may also be an early warning sign of prostate cancer. Some men with prostate cancer do not have symptoms, while others will see many of the same symptoms witnessed with BPH and overactive bladder.

According to the National Cancer Institute, prostate cancer cells are slow-growing and may have already advanced significantly by the time you see the symptoms. Finding it early is the key. If you have BPH or another risk of prostate cancer, you should have a regular prostate cancer screening.

There is no standard test for prostate cancer, but there are two commonly used tests. The PSA (Prostate Specific Antigen) test is a blood test that measures the level of PSA in the blood. When cancer cells are present in the prostate cells, the levels will generally be elevated, letting the doctor know that further testing, such as a prostate biopsy, may be necessary.

The other test used is the DRE (digital rectal examination). The doctor inserts a gloved finger into the rectum to feel for enlargement or masses in the glandular tissue. Detecting an enlarging prostate or extra prostate tissue indicates issues with prostate health and may be a sign that prostate cancer treatment is needed.

BPH Diagnosis and Treatment

When diagnosing BPH, your doctor will consider other risk factors as he evaluates you. It is rare to see prostate gland enlargement in men less than age 40, though some men see mild symptoms. By age 60, one-third of men will experience moderate to severe symptoms; by age 80, that increases to around half.

Family history and health history also contribute to your risk of BPH. Relatives with prostate problems increase your chances of having issues, and certain diseases and conditions such as heart disease and diabetes raise your risk as well. Obesity is also a major contributing factor to the development of benign prostate hyperplasia.

The treatment options for BPH vary on the clinical implications. The supplement Saw Palmetto is widely touted as helpful for many men in reducing BPH symptoms and slowing the progression of the enlargement, however this is unproven in scientific studies. A prescription medicine called Flomax relaxes the muscles in the prostate and neck of the bladder, making it easier to urinate, however often has significant side effects.

Minimally Invasive Procedures for BPH

Thanks to technological advancements, minimally invasive procedures are now available for men coping with BPH. Doctors perform these minimally invasive procedures with tiny cuts (incisions) or use tube-style instruments to insert into the urethra. These procedures relieve symptoms of BPH better than medicines. Other benefits include faster recovery and less pain than traditional, open surgery and fewer risks. They include:

However, each of these procedures involves some risk, including a very high rate of postoperative retrograde ejaculation, extended recovery periods, and the need to repeat the treatment. In some cases, erectile dysfunction (up to 15%) and/or urinary incontinence (up to 1-2%) can result.

Prostate Artery Embolization: A Superior, Minimally Invasive Treatment for BPH

Interventional Radiologist Dr. Adam S. Gropper, the founder of Prostate Specialists of Miami, performs the Prostate Artery Embolization or PAE in-office, with the patient under mild sedation. During the procedure, Dr. Gropper inserts a tiny catheter into either the radial artery at the wrist or the femoral artery at the top of the leg and guides it to the prostate artery on both sides of the enlarged prostate gland. Once positioned next to the prostate, the catheter delivers microscopic spheres to block blood flow. Blocking the blood supply to the prostate causes it to shrink, thereby dramatically reducing symptoms.

Once the procedure is complete, the patient can return home a few hours later and look forward to an easy recovery. Most patients notice an improvement in their symptoms within two to three weeks. Prostate artery embolization has a high success rate, with 90 percent of men experiencing relief after the procedure. The research concludes that PAE offers long-term success in treating an enlarged prostate, with 82 percent of men still enjoying a successful PAE three years after their procedure.

Best of all, with PAE, there are NO unwanted sexual side effects. PAE does NOT negatively affect sexual performance. Risk of urinary incontinence or erectile dysfunction is virtually zero.

Contact Prostate Specialists of Miami

Coping with overactive bladder and BPH symptoms is stressful. At Prostate Specialists of Miami, Dr. Adam Gropper and his staff focus on providing state-of-the-art vascular procedures in a patient-centered atmosphere. With decades of experience in all facets of interventional radiology, we have the skills and knowledge to diagnose and treat your BPH and overactive bladder issues.

For more information about BPH, prostate problems, and other vascular issues, call us at (786) 500-5347.

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Prostate Specialists of Miami
15400 Biscayne Boulevard #104
Aventura, FL 33160

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