Can I tell if my prostate is enlarged?

For many men, disturbing sleep to make annoying trips to the bathroom every night may be the first sign of an enlarged prostate. Other symptoms include: Difficulty urinating. Having a weak flow during urination.

buschcenter.com - What Are the Signs of an Enlarged Prostate? - Busch Center

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The most common prostate-related issue for men over 50 is prostate enlargement. By age 60, over half of men will have Benign Prostate Hyperplasia (BPH), or non-cancerous prostate enlargement. By age 85, that number increases to 90%.

Causes

The prostate is approximately the size of a walnut in younger men but it can grow to be much larger when the cells of the prostate gland begin to multiply as they get older. An enlarged prostate can cause no visible symptoms but will eventually impact urinary and erectile functions if not properly treated. Enlargement does not necessarily mean a person has prostate cancer, but the presence of cancerous cells can lead to more inflammation and a more enlarged prostate.

Symptoms

When a prostate is enlarged, it puts pressure on the urethra causing it to narrow. This requires the bladder to contract more forcefully to push urine through it and out of the body. This additional strain causes the bladder muscle to become stronger, thicker, and more sensitive, making it contract even when it contains small amounts of urine. This is why frequent urination often becomes an issue for older men. Eventually, the bladder is unable to compensate for the narrow urethra so urine can remain in the bladder, and it’s not completely emptied. For many men, disturbing sleep to make annoying trips to the bathroom every night may be the first sign of an enlarged prostate. Other symptoms include:

Difficulty urinating

Having a weak flow during urination

Needing to urinate urgently or frequently

“Stop-start” urination

Leakage or urinary incontinence

Inability to completely empty the bladder

Prone to urinary tract infections

Results

Men suffering from enlarged prostate symptoms should get a prostate MRI screening known as a Biparametric MRI or bpMRI. A bpMRI provides Dr. Busch with the information necessary to accurately detect the degree of enlargement, and determine if any cancerous tissue is present. This screening is performed with the patient comfortably lying on their back in the MRI machine while accompanied by a technician available by two-way intercom. Busch Center goes a step further by providing a visible radiologist. The procedure is simple and painless, usually taking only 30 minutes to perform. The benefits of screening with an MRI are:

It detects prostate cancer with 90% accuracy.

The procedure uses no needles and has no contrast and radiation.

It reduces the need for random, blind prostate biopsies.

It provides earlier, more accurate diagnosis of prostate cancer, leading to better outcomes. It aids in determining the best method of treatment for BPH and prostate cancer. Following the bpMRI, Dr. Busch sits with patients to review their scans with them, talking through the image and sharing next steps depending on their unique circumstances. One effective option to treat BPH is the TULSA Procedure, a treatment Dr. Busch has pioneered in the U.S. It’s an incision-free, minimally-invasive procedure using guided MRI imaging and laser ablation to remove excess prostate tissue. Contact us to schedule your bpMRI or to learn if the TULSA Procedure is right for you.

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How do I prepare for a cystoscopy?

There is no “prep” required. There is no need to come in with a full bladder. We will ask you to empty the bladder prior to the procedure. You may eat before your visit.

brighamandwomens.org - Cystoscopy Patient Instructions - Brigham and Women's Hospital

Cystoscopy Instructions (pdf)

What is Cystoscopy?

Your doctor has recommended that you have a cystoscopy. This is a procedure that involves using an instrument called a cystoscope to look at the lining of the bladder (the area where the urine is stored), the opening of the ureters (the tubes that connect the kidney to the bladder), and the urethra (the tube that runs from the bladder to the outside of the body). The cystoscope is a thin instrument about the thickness of a pencil and is similar to a catheter. It has a lens at the end so the inside of the bladder can be seen. It is usually attached to a television screen, so both you and your doctor will be able to see the inside of the bladder. The procedure is usually performed in the office. It does not require any anesthesia and lasts for approximately 5 minutes. While the cystoscope is being inserted you may feel mild discomfort for a few seconds. Once the cystoscope is in the bladder most of the discomfort should subside.

Why is Cystoscopy Necessary?

The cystoscopy procedure is ordered for a variety of reasons. These can include blood in the urine, frequent urinary tract infections, recurrent urinary incontinence, urinary frequency, painful urination, urinary retention (unable to empty completely), or problems from previous urinary tract surgery.

Preparation for Cystoscopy

There is no “prep” required. There is no need to come in with a full bladder. We will ask you to empty the bladder prior to the procedure. You may eat before your visit. Please take your regularly scheduled medications for the day, with the exception of aspirin or aspirin-based medications.

If you have any questions, please call the office at (617) 732-4838.

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