Is This Common Male Problem Keeping You Awake at Night?

When you drift off to sleep at night, your body and mind are preparing to be healed and repaired, especially during the deepest sleep stages known as REM. Getting consistent, uninterrupted sleep allows your body to reach this restorative stage of sleep, which helps prevent obesity and chronic illnesses including heart disease and diabetes.

Often, sleep apnea is the cause of sleep disruptions, but for men 50 and over, there is another prime suspect: benign prostatic hyperplasia (BPH), also known as an enlarged prostate.

We checked in recently with urologist Dr. Meredith Perry to learn more about BPH, its symptoms and treatment options. Dr. Perry joined Shore Physicians Group in January in affiliation with Jersey Urology Group and sees patients at SPG’s office located at 649 Shore Rd. in Somers Point.

Symptoms of an Enlarged Prostate
The prostate is a walnut-sized gland that sits below the bladder and plays an important role in sexual function. At around age 25, the prostate gland begins to slowly grow. By around age 50, half of men will have a prostate gland large enough to interfere with their ability to urinate – and their quality of life.

“Symptoms of BPH including frequent urination, difficulty starting urination, a weak or slow flow, difficulty or strain with urination, and a feeling that the bladder is never fully emptied,” says Dr. Perry.

“A lot of the men I treat have been struggling with their BPH symptoms for quite some time, but only come to see me at the urging of their spouse because the symptoms interfere with their lives as well.”

Dr. Perry says in addition to interrupted sleep from frequent awakenings, there are many other ways BPH interferes with patients’ lives.

“Many patients are reluctant to go on car rides because of the need to stop frequently to use a restroom. When they do go out, they have to constantly be aware of where the restrooms are located. It can also take ten minutes to use the bathroom due to the weak flow, which is disruptive as well. My goal as their urologist is to provide patients with an effective treatment that can help them get their quality of life back.”

Treatment Options
Dr. Perry’s first course of action for patients with BPH is to start them on a medication. There are many medications out there that either relax the muscles in the bladder and prostate, or stop prostate growth and reduce its size and help relieve symptoms. However, Dr. Perry is quick to note that these medications do not fix the problem. The patient will need to take the medication daily for the rest of their life. There are also unwanted side effects, so it is important patients are aware of this.

“Medications are really just a Band-Aid, but what BPH patients really want is a fix. Luckily, there are procedures that can actually fix the problem.”

Dr. Perry says the size of the prostate will dictate which procedure is best for the patient. For prostates on the smaller end of the spectrum, there are minimally invasive options that can have the patient back to their normal lives in a day or two. These procedures are called UroLift® and Rezūm. Another procedure, known as a resection, is slightly more invasive but has almost immediate results. For the largest prostates, however, Dr. Perry recommends a prostatectomy, or removal of the prostate. While the previously mentioned procedures can be performed at Shore Medical Center, Dr. Perry prefers to send her patients in need of a prostatectomy to Penn Medicine because they perform these procedures more frequently.

Although there are side effects and discomfort from these procedures, Dr. Perry says most do not last long and are a small price to pay in order to get their freedom back.

“An enlarged prostate really can hinder a man’s ability to enjoy life fully,” says Dr. Perry. “The good news is that we can treat it, and get them back to the life they enjoyed before BPH.”

Risks of Not Treating an Enlarged Prostate
While BPH is by definition ‘benign’ in the sense that the overgrowth is not cancerous, an enlarged prostate can be dangerous if left untreated.

“The longer the bladder pushes against an outlet obstruction, the greater the risk is that the patient will experience bladder failure in the future. That’s when the bladder basically gets tired and shuts down. This can lead to kidney failure over time, as well as a need for permanent catheterization in order to empty the bladder,” says Dr. Perry.

“Another reason to see a urologist when you have BPH symptoms is that prostate cancer can present like BPH. That’s why it’s important to come see me as soon as possible – nobody wants that outcome.”

About the Appointment
In addition to addressing a patient’s BPH concerns at the visit, Dr. Perry also takes the opportunity to perform a prostate cancer screening for men age 55 or older. Prostate cancer is the most common cancer in men, but it is also treatable when discovered in its early stages.

“I understand visiting a urologist is not everyone’s favorite thing, so I like to address prostate cancer at the appointment as well, killing two birds with one stone. I encourage anyone who is experiencing BPH symptoms or age 55 or older to schedule an appointment with me,” says Dr. Perry.

Dr. Perry sees patients at the Shore Physicians Group office in Somers Point Tuesdays through Fridays. To schedule an appointment with Dr. Perry, call 609-365-6241.