September is Prostate Cancer Awareness Month, a timely reminder for men to pay attention to urinary changes and talk with a healthcare professional about prostate health.
One common condition is benign prostatic hyperplasia, or BPH. This is a noncancerous enlargement of the prostate that becomes more common with age. It can cause symptoms that affect sleep, work, travel, exercise and everyday comfort.
“The good news is that people do not have to just live with this condition,” says Daniel Higgins, MD, of ThedaCare Urology Care in partnership with the Wisconsin Institute of Urology. “From lifestyle changes to medications to innovative, minimally invasive procedures like Aquablation®, many effective treatments are available.”
What is BPH?
The prostate is a small gland located below the bladder. The urethra — the tube that carries urine out of the body — passes through the prostate.
As the prostate grows, it can squeeze the urethra and make it harder for urine to flow. That pressure can lead to lower urinary tract symptoms, such as a weak stream, frequent urination or waking often at night to use the bathroom.
BPH becomes more common after age 40 and is especially common after age 50. Between ages 50 and 60, around 50% of men will develop BPH. That jumps to 70% after age 60 and 80% to 90% after age 70.
Common signs and symptoms include:
- Needing to urinate more often, especially at night
- A sudden or urgent need to go
- Trouble starting urination
- A weak stream or a stream that starts and stops
- Dribbling after urination
- Feeling like the bladder is not fully empty
- In more serious cases, urinary tract infections, bladder stones, blood in the urine or inability to urinate
Impacts on Daily Life
BPH is often frustrating because it can disrupt routines.
“A person may avoid long drives, movies or activities because they worry about finding a bathroom,” Dr. Higgins says. “Waking up multiple times at night can cause daytime fatigue. Urgency can make exercise, errands or social events stressful.”
Over time, symptoms can affect confidence, relationships and quality of life.
Diagnosis of BPH
A urology evaluation usually starts with a conversation about your symptoms and medical history. Your doctor also may recommend a physical exam and tests to rule out other causes, such as infection, bladder problems or prostate cancer.
You may undergo:
- Digital rectal exam to estimate prostate size
- Urine test to check for infection or blood
- Blood tests, including kidney function tests and sometimes prostate-specific antigen, or PSA
- Urinary flow test to measure the strength of the stream
- Postvoid residual testing to see how much urine remains in the bladder after urinating
- In some cases, ultrasound, cystoscopy or bladder function testing
Treatment of BPH
Treatment depends on the severity of symptoms, prostate size, overall health and personal goals. For mild symptoms, a doctor may recommend watchful waiting and lifestyle changes.
“If symptoms become more bothersome or complications develop, we can consider minimally invasive procedures or surgery to remove or reduce extra prostate tissue and improve urine flow,” Dr. Higgins says.
Treatment options can include:
- Lifestyle changes: Limiting evening fluids, reducing caffeine or alcohol, timed bathroom visits and bladder-training strategies.
- Medications: Alpha blockers may relax muscles to improve urine flow. 5-alpha reductase inhibitors may shrink the prostate over time. Some people need a combination approach.
- Minimally invasive procedures: Outpatient procedures offer an option with fewer cuts and shorter recovery times.
- Surgery: A surgeon performs these procedures through the urethra. For very large prostates, other surgical approaches can remove obstructing tissue. This includes Aquablation.
What is Aquablation?
Aquablation at ThedaCare is a minimally invasive surgical treatment for BPH. It uses advanced imaging, robotic guidance and a heat-free, high-pressure waterjet to remove extra prostate tissue.
During the procedure, the care team creates a personalized map of the prostate and uses that to precisely remove tissue that is blocking urine flow. Aquablation is considered groundbreaking because it combines precision planning with heat-free tissue removal.
“In the past, traditional procedures often used heat, cutting or electrical energy,” Dr. Higgins says.
“The waterjet approach of Aquablation helps surgeons remove the right amount of tissue.”
Aquablation reduces risk to nearby structures that impact urinary control and sexual function. It can be a good option for a broad range of prostate sizes, including larger prostates that may have fewer minimally invasive choices.
Expert Urology Care, Close to Home
Wisconsin Institute of Urology is now part of ThedaCare, helping ensure access to close-to-home care.
For people dealing with BPH, this can mean easier connections between primary care, urology, diagnostic testing, surgical services and follow-up care. It also supports access to advanced urologic treatments and a collaborative team focused on helping patients find the right option for their needs.
“If you have symptoms of BPH or other prostate-related concerns, don’t hesitate to seek care,” Dr. Higgins says. “Our team is here to help you reclaim your quality of life.”
