New Procedure Brings Relief to Patients with Enlarged Prostate

What’s it like living with benign prostatic hyperplasia? For years, Octavio Correa lived with symptoms that quietly shaped his daily routine and limited his sense of freedom.

The 68-year-old energy management specialist had been careful about his prostate health for decades.

“They’ve been checking my prostate since I was 40, so that was almost 30 years ago,” Mr. Correa says. “It was fine until I got to 50-plus. That’s when it started getting large and the problems started popping up. The longer the time went by, the worse it got.”

It disrupted his sleep, limited his outings and created the kind of urgency that can quietly take over a person’s life. Eventually, he was diagnosed with benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland.

“BPH influenced my life in many ways,” says Mr. Correa. “The symptoms became significant enough that they affected many of my day-to-day decisions and activities.”

(Watch now: What’s it like living with benign prostatic hyperplasia? See how a simple surgical procedure at Bethesda Hospital cured Octavio Correa’s BPH and restored his quality of life. Video by Raphael Alvarez, Plum Productions.)

A Common Problem for Aging Men

BPH becomes increasingly common as men age, says Rair Jose Valero, M.D., a urologist with Baptist Health Urology in Boynton Beach.

“At least 60 percent of the patients in my practice have some degree of BPH, and age is the main risk factor,” he notes.

Many men begin noticing distinct changes in urination as the prostate grows.

“After 40, every man will experience an enlargement of the prostate,” Dr. Valero explains. “The first and most obvious symptoms will be related to urination. They will notice greater frequency and urgency, a weaker stream, and dribbling at the end. Waking up at least once at night to urinate becomes routine.”

These symptoms can be frustrating for men—and concerning for spouses or partners who see them struggling. BPH can affect sleep, travel, intimacy, work and everyday confidence.

Controlling BPH

Medications such as tamsulosin (Flomax) may help some patients. Others may need a minimally invasive procedure or surgery, depending on the size of the prostate, severity of symptoms, bladder function and personal goals.

Mr. Correa had tried the usual path.

“I was seeing a doctor, and they did biopsies, scans. They did everything in the book but there was no solution. Medications never did anything,” he says.

When Medications Aren’t Enough

By the time Mr. Correa met Dr. Valero, his BPH had become severe.

“He came to me after a few years of treatment with medication, without symptomatic improvement,” Dr. Valero notes. “We determined that he had a severe enlargement of the prostate with some modifications of other organs already underway as a result.”

Dr. Valero explained what was happening in a way Mr. Correa could understand.

“He drew it out for me on the examining bench paper,” Mr. Correa recalls. “He showed me where the prostate is blocking the flow and what he was going to do to unblock it.”

The option Dr. Valero recommended was single-port transvesical enucleation of the prostate, or STEP—also called robotic enucleation. STEP is a minimally invasive robotic surgery designed to treat significant prostate enlargement, especially when the gland is large enough that standard office-based BPH procedures may not be the best approach.

“STEP is the newest procedure that we offer for treatment of severe enlargement of the prostate,” Dr. Valero says. “I’ve done many of these procedures at Bethesda Hospital and the outcomes have been very good.”

How STEP Works

According to Dr. Valero, your prostate is comprised of a capsule on the outside and the adenoma, an inner core of tissue. Over time, the adenoma can grow and eventually cause partial or complete obstruction of the urethra, blocking normal urine flow.

“During STEP, we access the prostate through the bladder using a single-port robotic system and remove, or shell out, the adenoma while leaving the outer prostate capsule in place,” explains Dr. Valero.

For Mr. Correa, that explanation made sense immediately.

“That was what impressed me the most,” he says. “He said, ‘Your prostate doesn’t need to come out. We just need to clean out the inside, like a Roto-Rooter, and you’ll be fine afterwards.’”

Dr. Valero says the procedure is done through a single incision, usually about 3.5 to 4 centimeters, in the lower abdomen. The robotic instruments and camera enter through one port, allowing the surgeon to work inside the bladder and remove the obstructing prostate tissue.

Recovery After STEP

After surgery, some patients can go home the same day but most patients typically spend one night in the hospital, according to Dr. Valero. Patients experience minimal pain and will have a Foley catheter for about a week after surgery to drain their bladder. Once it is removed, many patients notice a dramatic improvement in their symptoms.

“When we remove the Foley catheter a week later, they usually experience a complete resolution of their BPH symptoms,” Dr. Valero says. “For them, it’s a huge relief.”

As with any surgery, STEP is not the right choice for every patient. “The best treatment depends on each man’s symptoms, prostate size, anatomy, medication history, bladder function and personal preferences,” Dr. Valero emphasizes.

Life after BPH

For Mr. Correa, the difference the STEP procedure made has been life changing. Before surgery, urgency ruled his day. After STEP, he regained control of his bladder, giving him a welcome improvement in his quality of life.

“It used to be that when I got the urge, I would have to go NOW,” Mr. Correa says. “Now when I get the urge, I can wait 30 minutes, 45 minutes.” The urinary urgency he used to dread was finally gone.

Dr. Valero says Baptist Health Urology is able to offer a range of BPH treatments and tailor care to each patient’s needs. For men who are quietly limiting their lives because of urinary symptoms—and for wives or partners who notice the interrupted sleep, anxiety and constant planning—his message is simple: BPH is common, but suffering in silence doesn’t have to be.

“At Baptist Health Urology, we have the ability to guide patients and to offer multiple options of treatment that can improve their quality of life,” Dr. Valero says.

Mr. Correa’s only regret is that he did not find the option sooner.

“I’m fantastic. Everything went smoothly. Everybody at Bethesda Hospital took good care of me,” he says. “If I had known about the results of this surgery, I would have done it sooner.”

Click here for more information on the treatments and specialists available at Baptist Health Urology.