Treatment for High-Volume Enlarged Prostate

July 12,2022 |
Doctor talking to his smiling patient

The prostate is a small, walnut-sized organ that sits below the bladder and in front of the rectum. It’s an essential part of the male reproductive system, as it’s responsible for creating the fluid necessary for semen to travel out of the body. The prostate is the only organ that never stops growing and, therefore, can cause problems if the growth is expedited or rapid. While most men don’t suffer from problems associated with enlarged prostate until they’re older, it can still affect younger men. The faster the growth rate, the sooner the complications will arise. If this occurs, it’s important to understand some of the treatment options for high-volume enlarged prostate.


What is Enlarged Prostate?

In most men, the prostate begins to grow around the age of 25 or 30 and continues until the end of life. The reason that this occurs is still unknown and it’s considered nearly impossible to prevent or suppress growth. If the growth rate is slow, men don’t tend to experience noticeable symptoms or issues. However, in many instances, the prostate becomes enlarged enough to impact urinary function. When this occurs, it’s referred to as enlarged prostate or benign prostatic hyperplasia (BPH).

Symptoms of Enlarged Prostate

Men who have enlarged prostate will eventually show one or more symptoms. However, these are often mistaken for symptoms of other urologic conditions, so it’s important to schedule a visit with your urologist to ensure the proper diagnosis is made. Some of the most common symptoms of benign prostatic hyperplasia (enlarged prostate) are as follows:

Symptoms that are left untreated can develop into more serious problems, so always see your doctor at the earliest sign of a problem. While it can feel embarrassing to talk about, urologists specialize in these conditions and seeking treatment will help you find relief from problematic or intrusive symptoms.

One of the best ways to reduce the risk of adverse side effects caused by enlarged prostate is to live a healthy, active lifestyle. You should be eating a diet that’s filled with healthy, nutritious foods, reducing your intake of alcohol, and getting an adequate amount of exercise each day. It’s also important to quit smoking and maintain a healthy weight. If you have any questions about how to reduce your risk of enlarged prostate, contact your urologist.


Different Causes of Enlarged Prostate

Unfortunately, there’s currently no known cause of enlarged prostate or high-volume enlarged prostate. One theory why some men may be more susceptible to rapid growth is due to fluctuations in hormone levels. This could be related to testosterone or growth hormones, but more research is needed to definitively link the two together. Additionally, some risk factors that may increase your chances of developing high-volume enlarged prostate include older age, family history, the use of beta blockers, pre-existing conditions like diabetes or heart disease, obesity, and living a sedentary lifestyle. If someone in your family is suffering from high-volume enlarged prostate, talk to your urologist about what you can do to mitigate your risks. Similarly, it’s important to schedule regular visits with your urologist after turning 40 for preventative screenings.


What is High-Volume Enlarged Prostate?

Every case of enlarged prostate is different, as some men experience faster growth rates than others. If you begin to have any symptoms of BPH, it’s important to schedule an appointment with your urologist. During this time, they will perform a digital rectal exam or use an ultrasound for prostate imaging. This will give your urologist a clear understanding of the size of your prostate, which provides further information for effective treatment.

The prostate is commonly measured in grams. If your urologist determines that your prostate is over 80 grams, it’s considered very enlarged, or high-volume enlarged prostate. While this can seem intimidating, it doesn’t necessarily mean that you’ll experience worsened problems. In fact, the size and symptoms don’t always correspond and there are several instances of individuals who have high-volume enlarged prostate without noticeable symptoms.

If you experience high-volume enlarged prostate without symptoms, many urologists will recommend simply observing your body for any changes. Since enlarged prostate isn’t technically a concern without symptoms, this is often the best course of action. However, if you’re experiencing symptoms, it’s important to undergo the proper treatment plan to reduce your risk of complications and discomfort.

The most common complications of untreated high-volume enlarged prostate are urinary retention, urinary tract infections, bladder or kidney stones, and bladder or kidney damage.


High-Volume Enlarged Prostate Treatment Options

Men who experience noticeable symptoms of high-volume enlarged prostate should seek treatment to reduce the risk of further complications. Luckily, there are several options available to alleviate discomfort and provide you with ongoing relief. Depending on the severity of your symptoms, your urologist will likely begin with having you make some lifestyle changes. This includes eating a healthy diet, eliminating or reducing caffeine and alcohol intake, and performing pelvic floor exercises to help improve overall urologic health. If there is no noticeable improvement, your doctor may move on to medications or minimally invasive procedures.

Individuals with high-volume enlarged prostate who don’t find relief from other treatment options will usually have to undergo surgery. There are four primary options that can be used to address the issue and alleviate symptoms. These include an open prostatectomy, transurethral resection of the prostate (TURP), holmium laser ablation of the prostate (HoLAP), and holmium laser enucleation of the prostate (HoLEP).

Open Prostatectomy

During an open prostatectomy, a surgeon will make a small incision to remove some of the high-volume enlarged prostate. While it was commonly used as the preferred method in the past, today’s surgeons prefer alternative, less invasive approaches that produce fewer side effects.

Transurethral Resection of the Prostate (TURP)

One of the alternative treatment options is a transurethral resection of the prostate. The goal of this surgery is the same as an open prostatectomy—to remove some of the tissue of the high-volume enlarged prostate to alleviate symptoms. However, inside of performing the surgery through an incision, the surgeon will access the prostate through the urethra with the help of a microscopic camera. Prostate tissue will then be removed to help alleviate symptoms, open the urethra, and remove some of the excess pressure being incurred by the bladder. A TURP uses bipolar energy to reduce the cellular structure of the prostate, so there are still some side effects. Most commonly, these include infection, bleeding, scarring, the need for a repeated procedure, and in some cases, erectile dysfunction.

Holmium Laser Ablation of the Prostate (HoLAP)

This is similar to a TURP procedure, but instead of using bipolar energy, excess prostate tissue is vaporized using a high-powered holmium laser. This targets prostate tissue and essentially evaporates them on the spot. This can help individuals restore a strong urine flow and alleviate symptoms of benign prostatic hyperplasia. Similarly, using a laser to reduce the size of the prostate can reduce your risk of bleeding and lower the chances of needing a catheter during recovery. The holmium laser is also more effective than the process used to remove tissue in a TURP surgery, therefore the time under anesthesia is minimized.

Holmium Laser Enucleation of the Prostate (HoLEP)

As the name suggests, a holmium laser enucleation of the prostate is similar to the HoLAP procedure in that it uses a holmium laser to reduce the size of high-volume enlarged prostate. However, during this procedure, the excess tissue is enucleated rather than ablated (evaporated). This means that the separated tissue will be removed using a second instrument. This allows a pathologist to further inspect affected tissue and test for prostate cancer. Although rare, it has been found that about 5% to 10% of men who need to undergo surgery for enlarged prostate have the presence of prostate cancer in tissues. This allows for swift treatment and a stronger prognosis.

If you’re experiencing any symptoms of high-volume enlarged prostate, don’t hesitate to schedule an appointment with your urologist. Getting the proper diagnosis is essential to addressing any underlying causes and finding relief from your symptoms. For more information on improving your urologic health, or for support of common urologic conditions like enlarged prostate, contact Byram Healthcare today. 

Byram Healthcare is a member of the National Association for Continence’s Trusted Partners Program, whose mission is to provide quality continence care through education, collaboration and advocacy. We continue to build partnerships in the clinical community to ensure we focus on what’s best for the patient.