“Don’t suffer silently.”
By the age of 60, 50% of men will be diagnosed with BPH or Benign Prostatic Hyperplasia, and overall, up to 80% of men will develop BPH, according to estimates from the American Urological Association.i
But some men will avoid treatment for their enlarged prostate because medications or medical procedures can adversely affect sexual function, according to Dr. Jed Kaminetsky, M.D., a clinical assistant professor at NYU Medical Center and a board-certified urologist at University Urology.
“That really inhibits treatment,” Dr. Kaminetsky said in a recent addition of the “Sexology” podcast hosted by Dr. Nazanin Moali. “Men don’t want to be treated for their prostate because they associate treatment with (negative) sexual side effects.”
Dr. Kaminetsky discussed minimally invasive procedures to treat BPH without affecting sexual function.
“The symptoms that men find most annoying due to enlarged prostate are getting up at night and urgency,” Dr. Kaminetsky said. “So that feeling that you know where every bathroom in the city where you live is at, and you always worry you’re going to have an accident.”
He noted that waking up constantly and not getting a good night’s sleep can also affect a man’s testosterone levels.
“The symptoms that men find most annoying due to enlarged prostate are getting up at night and urgency. So that feeling that you know where every bathroom in the city where you live is at, and you always worry you’re going to have an accident.”
The first line of therapy is typically medication, which either relaxes the prostate or shrinks it, according to Dr. Kaminetsky. But either class of medication can have sexual side effects, including erectile dysfunction or a decreased libido and orgasm, he said. Some medical procedures also carry the risk of sexual side effects, Dr. Kaminetsky said.
“The procedure I'm most excited about is called the iTind… It’s a temporary implant that we put into the prostate...,” he said. “What it does it is it remodels the prostate and gets very close to surgical results with no sexual side effects.”
The iTind is made up of three flexible nitinol (nickel titanium super alloy) struts that gently expand over a five- to seven-day period and does not require an overnight hospital stay. The temporary device is placed in the prostatic urethra during a procedure that can be done in a medical office. iTind reshapes the prostate by gently exerting pressure on the tissue to open three channels, allowing urine to flow and relieving lower urinary tract symptoms (LUTS) without the need for most patients to go home with a catheter.
A studyii has shown that the iTind procedure preserves sexual function for men with an enlarged prostate, and without a permanent implant, the procedure does not hamper any future treatment options. Implantation of the iTind device may cause urinary urgency, pelvic discomfort, dysuria or hematuria. In rare cases, iTind may cause urinary tract infection or acute urinary retention.
Dr. Kaminetsky urged men to take advantage of the treatment options available and reminded those in their lives to keep an eye out for warning signs of an enlarged prostate.
“If you see your friend or partner is running to the bathroom more than he should, or even if he’s not, he should every year come and get a prostate check and get his PSA (prostate-specific antigen) checked and make sure he doesn’t have prostate cancer,” Dr. Kaminetsky said.
"Don’t suffer silently.”
iUrologyhealth.org, Urology A-Z
iiChughtai B, Elterman D, Shore N, et al. The iTind Temporarily Implanted Nitinol Device for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Multicenter, Randomized, Controlled Trial [published online ahead of print, 2020 Dec 26]. Urology. 2020; S0090-4295(20)31520-X. DOI: 10.1016/j.urology.2020.12.022