Many men suffer in silence when they’re struggling with health conditions that affect their bladder or sexual function, such as an enlarged prostate, urinary incontinence or erectile dysfunction.
That’s too bad, considering how common – and treatable – these problems are.
“We have to find a way to inspire men to talk about these conditions and to realize there are safe and effective treatments that can improve their quality of life,” says Ronald Morton, M.D., chief medical officer, Urology, Boston Scientific.
For Men’s Health Month, we’re shining a light on these health issues, and some innovative solutions.
Benign prostatic hyperplasia (BPH)
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| Rezūm™ Water Vapor Therapy can significantly decrease the amount of tissue in the prostate -- often enough to relieve the symptoms of benign prostatic hyperplasia. |
What it is: BPH (also known as an enlarged prostate) is a non-cancerous enlargement of the prostate gland, which sits just below the bladder and surrounds the urethra. The prostate goes through two periods of growth: during puberty, when the gland doubles in size, and then again around age 25. After this, the prostate continues to grow, albeit slowly, for the rest of a man’s life. This is one reason why BPH becomes more common with age: It affects about 50% of men by age 60, 70% of men age 60 or older and around 90% of men by age 85.
As the prostate gets bigger, it can start to block the flow of urine. This can cause a need to urinate more often (especially at night); difficulty starting urination; a weak or interrupted flow; and a feeling that the bladder isn’t completely empty after urinating.
Treatment options: If watchful waiting or lifestyle modifications (such as getting regular exercise and limiting caffeine and alcohol in the evening) don’t work, medications such as alpha blockers (which relax the prostate and bladder muscles to improve urine flow) and 5-alpha reductase inhibitors (which reduce prostate size) may be considered. For moderate or severe forms of BPH, surgical options that cut away parts of the prostate tissue or remove the prostate entirely may be recommended.
For those who want to avoid the potential side effects that come with some surgical procedures, minimally invasive procedures may also be an option. These treatments can also reduce the size of prostate tissue or move prostate tissue away from the urethra using steam, high-velocity water, lasers or implants. During an outpatient procedure called Rezūm™ Water Vapor Therapy, for instance, a catheter is inserted into the urethra and steam is injected into the prostate, treating and removing excess prostate tissue. The result? “With Rezūm, there is a significant decrease in the amount of prostate tissue, which is often enough to open the urethra and relieve symptoms,” says Dr. Morton.
Sal Ciresi decided to try Rezūm Therapy on the suggestion of his urologist. Frequent urges to urinate were interfering with his work as an anesthetist, and medications didn’t help. “Rezūm helped me find the relief I was looking for and got rid of many of the daily limitations I was living with,” he says.
Male stress urinary incontinence (SUI)
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| A medical device like the AMS 800™ Artificial Urinary Sphincter can help control male stress urinary incontinence. |
What it is: When the muscles and tissues that support the bladder and help regulate the flow of urine are weakened or damaged, urine leakage can occur during movements that put pressure (a.k.a. stress) on the bladder, such as laughing, sneezing, coughing or lifting heavy objects. People with SUI may need to urinate more frequently and often feel the urgent need to get to a bathroom.
Approximately one in 10 men in the U.S. suffer from urinary incontinence, with rates rising for those over age 60. Men who are recovering from prostate surgery are at an increased risk to develop SUI.
For Lonnie Sims, experiencing SUI after a stage II prostate cancer diagnosis and a radical prostatectomy to treat it felt like adding insult to injury. “I was to the point of wearing a diaper and needing to be within feet of a bathroom,” says Sims. “It was humiliating.”
Treatment options: Pelvic floor exercises can help improve bladder control and reduce urine leakage. Lifestyle changes such as losing weight (if necessary) and reducing fluid intake (especially before physical activity) are also recommended.
If these don’t work – and they didn’t for Sims – more invasive options may be necessary to achieve continence. Medical devices such as urethral inserts or penile clamps can be used to help control urine flow. There are also surgical options to consider, such as the AMS 800™ Artificial Urinary Sphincter: a device implanted around the urethra that can be opened and closed manually to help prevent leakage.
When Sims’ urologist suggested the AMS 800, he went for it. In an hour-long outpatient procedure, a urologist placed a fluid-filled cuff around Sims’ urethra. Now, when Sims has the urge to urinate, he simply squeezes a small pump that relaxes the cuff and allows him to urinate normally. “This device changed my life,” he says.
Erectile dysfunction (ED)
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| With the AMS 700™ Inflatable Penile Prosthesis, men with erectile dysfunction can get sexual function back. |
What it is: Impotence, otherwise known as ED, is the inability to get and keep an erection firm enough to have sexual intercourse. And it’s common: One study notes that approximately one in five American men aged 20 and older suffers from some degree of ED.
A wide range of physical, psychological and lifestyle factors can be to blame, ranging from stress and anxiety to excessive alcohol use and lack of physical activity. Certain medications may cause ED. So can medical conditions like heart disease and diabetes, by impeding blood flow to the penis and the nerves that control erections. The normal aging process can also lead to loss of blood flow, due to the degradation of smooth muscle cells over time.
Treatment options: Fortunately, with the right treatment, most patients can find a treatment option for ED.
One place to start is by modifying behaviors and working to manage life stressors. Oral medications and hormone therapy may be effective. If they aren’t, medical devices such as vacuum devices, penile injections or surgically implanted devices can be considered.
John Hartman struggled with ED for years and then got in a motorcycle accident that shattered his pelvis, making his ED even worse. “I tried everything from medications to injections – nothing worked,” Hartman says. “I was miserable.”
A penile implant called the AMS 700™ Inflatable Penile Prosthesis was key to getting sexual function back. The implant comprises of a pair of cylinders that are placed in the penis during a surgical procedure, along with a fluid-filled reservoir in the lower abdomen and a pump in the scrotum. Men can then get an erection by squeezing the pump to send fluid from the reservoir to the penis. When finished, the pump sends fluid out of the cylinders and back into the reservoir. The penis returns to a soft, natural-looking state.
Now, ED isn’t even on Hartman’s radar: “The pump fixed so many things—for me and for my relationship.”
Learn more about Boston Scientific’s treatment options for benign prostatic hyperplasia (BPH), male stress urinary incontinence (SUI) and erectile dysfunction (ED).
Results from patient testimonies are not necessarily predictive of results in other cases. Results in other cases may vary. Speak with your doctor as individual recovery varies.
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