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Enlarged Prostates Are Very Common—and Treatment Has Never Been Easier

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Enlarged Prostates Are Very Common—and Treatment Has Never Been Easier


This article was produced in partnership with Lumenis

You vaguely remember your father complaining about his prostate. But, hey, it’s nothing for you to worry about, right? An enlarged prostate is something that happens to older guys. Except one day peeing doesn’t come as easily as it used to, and you’re heading for the bathroom more times than you can count. Uh-oh.

It’s not a fun subject, but if you’re dealing with an enlarged prostate, know you’re not alone. In fact, you’re in very good company. The condition, known in medical terms as benign prostatic hyperplasia (BPH), is surprisingly common. More importantly, treatment options have improved dramatically since when your old man dealt with it. So no more hiding in the bathroom. Let’s bring this into the open and break it down.

What are the symptoms of an enlarged prostate—or BPH?

The prostate is a walnut-sized gland that sits below the bladder and surrounds the urethra. Its job is to create ejaculatory fluid. As men age, their prostates often get bigger, and compress the urethra. When this happens, urine doesn’t flow freely out of the bladder—which means the top signs of BPH are the need to urinate frequently with a stream that dribbles out like a leaky faucet. You might also be getting up multiple times during the night to pee. Sometimes, you may be straining during urination. BPH is incredibly common, affecting around half of men in their 50s, and 90 percent of men in their 80s.

To be clear, we’re not talking about cancer. An enlarged prostate isn’t always dangerous if asymptomatic. You can have an enlarged prostate without it impacting your life. However, if you begin to experience symptoms, they’re unlikely to resolve on their own.

“In general, it’s progressive, and guys will have gradual worsening symptoms,” says James R. Johannes, M.D., a urologist in the Lehigh Valley Health Network in Allentown, Pennsylvania. Left untreated, BPH can cause major damage to the kidneys and bladder, and require much more extensive treatment.

How is BPH diagnosed and treated?

If your general practitioner suspects you have an enlarged prostate, they’ll send you to a urologist for diagnosis and treatment. The doctor will perform a digital rectal exam, a urinalysis, and bloodwork. You may be asked to take a urinary flow and volume test to see if your bladder is emptying, and to track your urination over the course of a couple days.

For most men, the first-line intervention is medicine. Some prescriptions relax muscles in the bladder and prostate to help with urine flow, while others can help shrink the size of the prostate. Sometimes they’re prescribed together. That’s why you should head to the doc as soon as you suspect something’s not right.

“In general, the earlier the better,” Dr. Johannes says. “Sometimes we see people when the cat’s already out of the bag, and they have severe problems.”

At this point, surgery is often a good option. Luckily, we’ve moved past the days when the procedure meant a few nights in the hospital and seeing blood in the urine. Newer laser technology, like MOSES, makes reducing prostatic tissue faster and less invasive. This means less bleeding and often no need for a catheter. Odds are you’ll go home that same day—always a big relief to patients.

You may hear your doctor refer to it as a HoLEP procedure, which stands for holmium laser enucleation of the prostate. That’s been around for decades. What’s improved drastically is the MOSES laser technology. The minimally invasive HoLEP surgery happens in three parts.

First, a resectoscope is placed in the urethra and a small camera is threaded to the prostate so the surgeon can visualize the blockage. Next, a laser is threaded through the resectoscope and is used to core out the tissue that’s blocking urine flow. Finally, a cutting tool “chews up” tissue until it’s very small and removes it.

Throughout the procedure, a laser is used to reduce bleeding. The whole thing takes around 90 minutes and odds are you’ll go home that same day, which is always a relief to patients. Incontinence or urinary leakage risk is very low, as is the risk for erectile dysfunction. And if you’re worried about re-operation—that the surgery didn’t do enough to relieve the BPH—fear not. An 18-year study from McGill University in Montreal found that 98.6 percent of patients did not require another surgery.

If it’s so easy, why do men avoid it?

In a prostate-sized nutshell, going to the urologist is a drag. It’s no fun to talk about urination, less so to consider surgery in those parts. No surprise, it’s often a wife or partner who pushes for a prostate check.

But knowing that BPH is incredibly common—and that treatment is as swift and non-invasive as ever—can help.

Gary, a retired police officer from Illinois, was one of those people who waited too long. By the time his family forced him to visit the emergency room, he was already in renal failure and had to urinate using a catheter. He teamed up with Dr. Amy Krambeck, a urologist at Northwestern Medicine in Chicago, who used the MOSES technology. “My recovery was not bad at all,” Gary recalls. He experienced a week or two of bleeding, typically with urination. “I am doing great. I feel like I’m about 18 years old again.”

The other big hurdle is the fear of prostate cancer.

Here’s some surprising news. “Rarely does prostate cancer cause urinary symptoms,” says Dr. Johannes. The prostate has an inner, fleshy part, called the transitional zone, and an outer area, called the peripheral zone, he explains. Most BPH occurs in the transitional zone, while most cancers are in the peripheral zone.

Of course, for any prostate-related symptoms, your doctor should do blood work that tests for prostate cancer markers. If you do have a BPH procedure with MOSES, or any surgery to reduce prostate size, your surgeon can send tissue samples for analysis. Prostate cancer can be very treatable and slow-growing, so it’s best not to let any big-C fears prevent you from vital early detection and treatment.

Back to BPH. While surgery, of course, will always remain a big, informed decision, just know your options for dealing with a very common condition are that much easier these days. The latest technology in prostate care can alleviate the process of undergoing important treatment from start to finish. And that’s no small relief.

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10 Best Porters to Drink Right Now

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A bottle of Deschutes Black Butte Porter




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Best Time-Under-Tension Workout for Total-Body Strength

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Barbell Back Squat


The key to 360-degree muscle: 90-degree eccentric isometrics. It might seem like we’re throwing a lot of geometry at you, but the concept behind time under tension (TUT) is simple, says Joel Seedman, PhD, owner of Advanced Human Performance: “Perform the lowering phase of a movement in a slow, controlled fashion, usually 3 to 5 seconds; pause in the stretched position, typically around 90 degrees; then perform the lifting phase in a powerful yet controlled fashion.” Believe us, a time-under-tension workout can humble even seasoned lifters…Eccentric isometrics are like the pressure cooker of training.

“Rather than mindlessly performing slow-tempo reps, you’re using the increased time under tension as a means to fine-tune your body mechanics and alignment, which requires more mental engagement and focus,” Seedman adds.

If you want to forge functional muscle mass and strength while simultaneously bulletproofing the joints and connective tissue, give this 10-move, full-body eccentric isometrics workout a go.

Directions

Perform the following moves as 90-degree eccentric isometrics following the above protocol. Use heavy weight, but not at the detriment of proper form. Rest 60 to 90 seconds between sets and 2 minutes between circuits. Perform once every 2 to 4 days for optimal results.

Best Time-Under-Tension Workout for Total-Body Strength

Circuit 1

Marius Bugge

A. Barbell Back Squat

Set a squat rack up with heavy weight, then grasp bar and step under it. Squeeze shoulder blades together, then stand to unrack bar and step back with feet shoulder-width apart. Inhale, hinge at hips and slowly bend knees to 90 degrees. Pause, keeping natural arch in low back, then extend through hips to powerfully stand. 3 x 4-6 reps

Athletic man wearing gray T-shirt and maroon shorts renegade row
Marius Bugge

B. Renegade Row

Start in the top position of a pushup with hands shoulder-width apart on moderate-to-heavy dumbbells (shown). Explosively drive right elbow back to row dumbbell toward ribs while balancing on opposite hand and feet. Pause, then slowly lower weight, stopping a few inches above floor. Switch sides after all reps are done. 3 x 5 reps each side

Circuit 2

Athletic man wearing gray T-shirt and maroon shorts doing renegade row Dumbbell Bentover Row in gym
Marius Bugge

A. Dumbbell Bentover Row

Stand with feet hip-width apart, holding two moderate-to-heavy dumbbells in front of thighs, palms facing you. Push hips back and hinge torso forward so it’s nearly parallel to floor, soft bend in knees. Dumbbells should be near shins. Drive elbows back to row weights toward ribs. Pause, then slowly lower down for 3 to 5 seconds. 3 x 4-5 reps

Athletic man wearing gray T-shirt and maroon shorts doing Incline Dumbbell Chest Press with Legs Raised 
Marius Bugge

B. Incline Dumbbell Chest Press with Legs Raised 

Set an adjustable bench to a 30- to 45-degree angle and lie back with dumbbells in either hand. Engage core and lift legs off floor, flexing feet. Press weights overhead, palms in. Slowly lower to 90 degrees, staying tight and compact. Pause, then drive weights up directly over chest. 3 x 4-5 reps

Circuit 3

Athletic man wearing gray T-shirt and maroon shorts doing Dumbbell Bulgarian Squat
Marius Bugge

A. Dumbbell Bulgarian Squat

Stand lunge-length in front of a flat bench, holding heavy dumbbells in each hand by your sides, palms facing in. Rest the ball on top (shoe’s laces) of your right foot behind you on the bench. Slowly lower your body until your front thigh is parallel to the floor. Pause, then drive through your heel to stand. Switch sides after all reps are complete. 2 x 3-4 reps each side

Athletic man wearing gray T-shirt and maroon shorts doing Single-leg Romanian Deadlift
Marius Bugge

B. Single-leg Romanian Deadlift

Stand with feet hip-width apart holding dumbbells or kettlebells. Drive right leg up, foot flexed, knee aligned with hip, making a 90-degree angle. Hinge at hips as you slowly lever your torso toward floor, lowering weights and driving right leg back for counterbalance. Hold, then squeeze glutes to reverse. 2 x 3-4 reps each side

Circuit 4

Athletic man wearing gray T-shirt and maroon shorts doing pullup
Marius Bugge

A. Pullup

Hang from a pullup bar using an overhand grip with legs extended and feet flexed. Engage lats and draw shoulders down your back, then pull yourself up until chin is higher than hands. Pause at the top, then slowly lower. Pause at bottom, then reset before your next rep. 2-3 x 4-5 reps

Athletic man wearing gray T-shirt and maroon shorts doing Kneeling Overhead Barbell Press
Marius Bugge

B. Kneeling Overhead Barbell Press

Hold a bar with moderate-to-heavy load at shoulder level with forearms perpendicular to floor. Kneel at end of bench with feet flexed to grip edge for support. Inhale, engage your core and glutes, then press the bar overhead, pushing your head forward so it passes your face, exhaling at the top.
Slowly lower until elbows are at 90 degrees, then hold to maintain tension. Begin your next rep from here. 2-3 x 4-5 reps

Circuit 5

A. Dumbbell Pushup

Place hands on dumbbells (this provides greater range of motion) at shoulder width and feet wider than shoulder width with just toes touching the ground. Keep head neutral and hips high to increase tension on core, chest and tris and reduce stress on spine. Slowly lower to the floor. Stop
once elbows hit 90 degrees, pause, then push up to start. 1-2 x 6-8 reps

B. Biceps Curl

Stand with feet hip-width apart with moderate-to-heavy dumbbells in each hand hanging by sides. Engage biceps to curl the weights up, keeping upper arms still. Pause at the top, then lower slowly. Don’t let arms drop all the way down to keep greater time under tension on biceps. 1-2 x 6-8 reps


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The Best Jump Ropes for a Killer Cardio Workout

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The Best Jump Ropes for a Killer Cardio Workout




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