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58 November 30 • 2017 jn Take time to understand symptoms and treatments. Prostate Health I t's not a health topic often discussed in the Jewish News, yet it's an important one that, according to estimates, affects nearly half of men between the ages of 51-60. And, during Men's Health Month, what better time to understand more about prostate health. For many men, the first sign of Benign Prostatic Hyperplasia, BPH, is an increase in nightly visits to the bathroom. Commonly called an enlarged prostate, BPH is a condition in which the pros- tate gland is enlarged but not cancerous. Although BPH seldom causes symptoms for men before age 40, its occurrence and symptoms tend to increase with age. In fact, 90 percent of men older than 80 are esti- mated to have symptoms. The prostate gland, located just below the bladder, is part of the male reproductive system. About the size of a walnut when a man is in his 20s, its primary function is to produce and secrete part of the seminal fluid that carries sperm. During male orgasm, the muscu- lar glands of the prostate help to propel the fluid, along with sperm, from the testicles through the tip of the penis during ejaculation. By the time a man is 40, the prostate may have grown slightly larger to the size of an apricot and, by age 60, to the size of a lemon. This enlargement can press against the bladder and urethra and slow down or block urine flow. "The cause for BPH is unknown, but risk factors include family his- tory, obesity and type 2 diabetes. For some men, the symptoms may be severe enough to require treatment," says Dr. Mitchell Hollander, a urologist affiliated with Beaumont hospitals in Royal Oak and Troy and co-president of the Michigan Institute of Urology. "Even so, many men put up with an enlarged prostate for years, losing sleep and risking urinary tract infections, blad- der stones and chronic kidney problems before seeing a doctor," Hollander says. "Unfortunately, delays to being diagnosed and treated can lead to complications and health risks." BPH TREATMENT "The gold standard and most com- mon treatment for BPH has been the Transurethral Resection of the Prostate (TURP)," he says. "This is a surgical proce- dure that helps men urinate better, but it often has significant side effects including prolonged catheterizations and bleeding. Because of these side effects, new mini- mally invasive techniques decreasing the obstruction have been developed over the past 25 years by using techniques such as thermal (heat), radio frequency, microwave or laser technologies to kill prostate tissue and improve a patient's symptoms. The problem with most of these methods is that the benefits are short-lived. "Today, there are new treatment options available, depending upon the severity of a patient's symptoms, how much they impact a man's daily living and the individual's preferences," Hollander says. "These include medications that help to stop the growth of the prostate, shrink the prostate or reduce symptoms of BPH." After taking two pills for the last six years to reduce the size of his enlarged prostate and slow its growth, Paul told his urologist, Dr. James Relle, that he didn't want to take the pills any longer. After some discussion, Relle informed Paul that if he were the right candidate, there was a new technique, the UroLift System Treatment, that required a simple surgical procedure to treat BHP and was receiving good results. "I explained that an enlarged prostate compresses on the ure- thra, making it difficult for urine to flow," says Relle, assistant professor of urology at Oakland University William Beaumont Medical School. "The UroLift device is placed through the obstructed urethra to access the enlarged prostate. Then small UroLift implants are perma- nently placed to lift and hold the enlarged prostate tissues out of the way, increasing the opening of the urethra. "The permanent implants are delivered through a small needle that comes out of the UroLift delivery device and into the prostate. The final step is removing the delivery device, leaving an open urethra that provides symptom relief. This is done without any cutting, heating or removal of prostate tissue. "The procedure was used in Europe and Australia for several years before it received approval by the FDA in 2013," Relle says. "Recently published was a five-year study of its results, demonstrating its safety and effectiveness over a five-year period. It RUTHAN BRODSKY CONTRIBUTING WRITER health continued on page 60 Dr. Mitchell Hollander Dr. James Relle ABOVE: Prostate and prostate with UroLift