Ahmed Mansour Elkenany, MDUrology
Robert Svatek, MDUrology
Thomas Rozanski, MDUrology
Learning something is wrong with your prostate can be alarming, but we’re here to help. Whether that be prostate enlargement, prostatitis or cancer, we’ll answer all of your questions and help you find the right path forward.
Conditions We Treat
Benign prostatic hyperplasia (BPH): Benign prostatic hyperplasia is also known as prostate enlargement. BPH can cause urination problems, such as increased frequency and urgency, a weak stream, and the inability to completely empty the bladder. Many men experience BPH as they age and may need treatment for an enlarged prostate.
Prostate cancer: Prostate cancer can be slow-growing or aggressive, confined to the prostate or spread to other parts of the body. Many men don’t have symptoms in the early stages, but if the cancer progresses, it may cause urination problems, erectile dysfunction, or blood in the semen. It is one of the most common types of cancer, and men over age 50 have the highest risk. Early diagnosis offers the best outcome.
Prostatitis: This condition causes swelling and inflammation in the prostate, which can cause painful, difficult, or frequent urination. You may also experience pain in your abdomen, lower back, pelvic area and genitals, or during ejaculation. Some men have flu-like symptoms as well. Prostatitis is most common in men under age 50. This condition can often be treated with medication.
Advanced Testing & Treatments
If your doctor suspects prostate cancer but past biopsies have been negative, we offer the highly advanced fusion-guided biopsy as a more precise method of screening for prostate cancer. The magnetic resonance-ultrasound (MR/US) fusion biopsy of the prostate (UroNav fusion biopsy system) reduces the number of tissue samples required and is both faster and less invasive than other biopsy methods.
We are also one of the few medical facilities in the nation to perform the ThuLEP and HoLEP procedures to treat benign prostatic hyperplasia.
Treating an Enlarged Prostate
We offer many options for treating an enlarged prostate. Treatment often depends on your age and overall health, the severity of your symptoms and how enlarged your prostate is.
Some of the options for treating BPH include:
- Lifestyle changes: When your symptoms are mild, you may decide not to have treatment. Some lifestyle changes can help, such as not drinking fluids right before bedtime as well as avoiding caffeine and alcohol. A healthy diet and physical exercise may help alleviate some symptoms.
- Medications: There are several medicinal treatment options for BPH. These include:
- Alpha blockers relax the muscles of the prostate and bladder neck, which can help urine pass more easily.
- 5-alpha reductase inhibitors can decrease the size of the prostate by preventing certain hormonal changes.
- Erectile dysfunction medication can also sometimes treat BPH.
- Surgery: If you have moderate to severe symptoms of BPH that persist despite lifestyle adjustments and medication, your doctor may recommend surgery.
Enlarged Prostate Surgery Options
The transurethral resection of the prostate (TURP) is a common surgery used to treat benign prostatic hyperplasia. While it is effective, there are some disadvantages, such as the risk of bleeding, electrolyte disturbances, or the need for more surgery later on. Here at University Health, we can give our patients another option.
ThuLEP and HoLEP procedures
In partnership with UT Health San Antonio, we’re one of the few centers in the country, and one of only two centers in Texas, that perform the ThuLEP procedure (Thulium Laser Enucleation of the Prostate) and the HoLEP procedure (Holmium Laser Enucleation of the Prostate) to treat benign prostatic hyperplasia.
The ThuLEP and HoLEP procedures are very similar. Both are minimally invasive, using a thin tube with a tiny camera at the end so the surgeon can view the prostate tissue. This tube, called a resectoscope, is inserted through the penis into the urethra. In each procedure, a laser is inserted into the tube and removes excess prostate tissue. The difference between the procedures is the type of laser used, either a thulium laser or a holmium laser.
What are the benefits?
These advanced, innovative procedures are much less invasive than the TURP procedure and have many other advantages, including:
- Patients typically spend less than 24 hours in the hospital
- Recovery time is quicker
- There’s little bleeding, so men taking blood thinners may be good candidates for one of these surgeries
- The procedures can be used on a prostate of any size
- There’s low risk of another surgery being needed
What are the side effects?
Some men who have either the ThuLEP or HoLEP procedure may experience temporary side effects such as:
- Blood in the urine for a few days
- Frequent or painful urination for a few days
- Post-operative stress urinary incontinence, though this improves over time
- Reaction to anesthesia
What to Expect
At your first appointment, our doctors will take a full health assessment. Then you may have one or more urologic tests as a preventive screening or to help your urologist determine a diagnosis.
When we have determined what urinary or genital issue you’re having, we will thoroughly counsel you on all available management options and help you decide what treatment option will most effectively address your condition and meet your goals. This can range from conservative management techniques to complex surgical reconstruction. Fortunately, our urologists are able to provide the full spectrum of reconstructive treatment options to our patients.