Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Benign prostatic hyperplasia (BPH) is an enlarged prostate gland. The prostate gland is located under the bladder in males. The urethra (the tube that carries urine and semen) passes through the prostate. The enlarged prostate may cause narrowing or blockage of the urethra. This can cause problems with urination.
BPH is a normal part of aging in men. It is caused by changes in hormone balance and cell growth. Five out of 10 men over 50 years of age will develop BPH. Nine out of 10 men over 80 years of age will develop BPH.
BPH causes many men to develop lower urinary tract symptoms. Your doctor can diagnose BPH by asking questions about your health and symptoms and by doing a physical exam.
BPH does not always require treatment. If your symptoms are mild or do not bother you, lifestyle management may work. Medications and surgical procedures are options in some cases.
Lower urinary tract symptoms may occur with an enlarged prostate. They include:
We can diagnose BPH by reviewing your symptoms, asking you questions, doing a physical exam, and assessing lab test results. This may include:
In some cases we may decide you need additional testing. This may include:
BPH is a normal part of aging in men. The enlarged prostate is thought to be caused by changes in hormone balance and cell growth. There may be a genetic role in the case of severe BPH requiring surgery prior to age 60. Men older then 50 have a greater chance of developing BPH. Why severe symptoms occur in some men and not in others is unknown. Ongoing research will add to our understanding of what causes BPH to develop.
Watchful waiting is recommended when symptoms are mild and not affecting your quality of life. If your symptoms are moderate to severe, treatment will depend on how much they bother you personally and may include medications or surgery.
Medicines are available to ease symptoms and/or to reduce the size of the prostate. Most men respond well to these medications. Once started, they need to be taken regularly to maintain the benefit.
Alpha-blockers relieve symptoms within a few weeks but do not stop prostate enlargement. Possible side effects include dizziness, lower blood pressure leading to fainting or light-headedness when standing up, ejaculation problems, headache, and nasal congestion. If you are having cataract surgery, we need to take that into consideration. Alpha-blockers can cause a pupil disorder (floppy iris) that interferes with eye surgery.
5-Alpha reductase inhibitors work to reduce the size of the prostate. They may take up to 6 months to improve your symptoms. One possible side effect, occurring in 6 out of 100 men, is a decreased desire for sex.
Many men benefit from combining alpha-blockers and 5-alpha reductase inhibitors over a period of time. The combination may be more effective than either medication alone.
According to the National Center for Complementary and Alternative Medicine at the National Institutes of Health, herbal remedies such as saw palmetto and pygeum have not been proven to be effective.
This minimally invasive procedure is used short-term in case of urinary retention (inability to urinate). A urinary catheter is a small tube that is passed through the penis into the bladder, allowing the bladder to be drained. This is usually done while waiting for medications to start working, surgery to be scheduled, or an infection to clear up. Catheterization can be intermittent (every 6 to 8 hours) or left in place for weeks at a time before it needs to be changed. In rare cases, it may be used as a long-term solution, with monthly adjustments.
There are 3 surgical treatments for BPH that do not require an incision but are regarded as invasive because it is necessary to go through the urinary opening in the penis in order to reach the prostate. All of these procedures are performed in the operating room under anesthesia.
Transurethral prostatectomy (TURP) is most commonly used. An instrument is inserted through the urethra. The section of the prostate that blocks the urine flow is removed using an electrocautery loop (hot wire).
Laser prostatectomy uses a laser beam to remove the part of the prostate that blocks the urethra.
Both procedures can effectively improve symptoms. Patients are able to leave the hospital within 1 to 2 days. The laser prostatectomy has a reduced risk of complications, but there is an increased chance for a second surgery and a longer period of discomfort with urination after the procedure. Both procedures have the potential to cause various complications, including:
Transurethral incision (TUIP) of the prostate is used for smaller prostates. This procedure widens the prostate in order to help reduce the pressure on the urethra caused by the prostate.
Simple open prostatectomy is for very large prostates, too large for TURP. This surgery involves:
Open prostatectomy improves symptoms but carries a higher risk of complications compared to other procedures. This includes an increased risk of bleeding, with the possible need for a blood transfusion, erection difficulties, and difficulty holding urine.
In deciding to have any of these procedures, you should consider your expectations for the results, the severity of your symptoms, and the possibility of developing complications.
Making lifestyle changes may help control symptoms and prevent your condition from worsening. Consider these changes:
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you. I may recommend other diagnostic studies, as needed. We can discuss surgery or less invasive therapies that may be appropriate. If you have severe symptoms, surgical treatment may be offered.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.