Putting Patients First

Welcome to Fifth Avenue Urology, the practice of Dr. Yaniv M. Larish. We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

Dr. Larish served as the former chief resident of Urology at Lenox Hill Hospital. Drs. Larish is focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. At Fifth Avenue Urology, we view the ability to practice medicine as a privilege, not a right. They treat their patients with respect, professionalism and compassion.

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Yaniv M. Larish, M.D.

dr-yaniv-larish-fifth-avenue-urology2 Dr. Larish is a urologist and surgeon treating women and men with a variety of urological conditions. His expertise is in treating complex kidney stones, enlarged prostates (BPH), incontinence, erectile dysfunction, infertility, and urological oncology (prostate, bladder, kidney, and adrenal cancers). He is an expert in general urology and is often consulted for second opinions.

Dr. Larish’s dedication to patients and their families drives his belief in prompt evaluation and care. He treats all his patients like family. As such, same day appointments are available for urgent issues and house calls can be made in select cases.

See our Main Site at www.FifthAvenueUrology.com

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Category Archives: BPH

BPH: Symptoms, Diagnosis, and Treatment

In this article, we will delve into BPH symptoms, diagnosis, and treatment options. Benign Prostatic Hyperplasia (BPH), also known as prostate gland enlargement, is a common condition that affects many men as they age. It occurs when the prostate gland, which is located beneath the bladder, grows in size and begins to squeeze the urethra, causing urinary symptoms. If you or someone you know is experiencing urinary problems, it’s essential to understand the symptoms, seek proper diagnosis, and explore the available treatment options.

urinary problems in men

BPH Symptoms, Diagnosis, and Treatment

Symptoms of BPH

BPH can cause a variety of urinary symptoms that can significantly impact a man’s quality of life. Some common symptoms include:

Frequent Urination: A need to urinate more often, especially during the night.
Urgency: A sudden and intense urge to urinate that may be difficult to control.
Weak Urine Flow: A weak or slow stream of urine during urination.
Difficulty Starting and Stopping: Difficulty initiating urination or stopping and starting the flow.
Incomplete Emptying: A feeling that the bladder is not completely empty after urination.

Diagnosis of BPH

If you experience any of the symptoms associated with BPH, it’s crucial to consult a healthcare professional for a proper diagnosis. The diagnostic process may involve the following:

Medical History: The doctor will review your medical history, including any urinary symptoms and their duration.
Physical Examination: A physical examination, including a digital rectal examination, will be performed to assess the size and condition of the prostate gland.
Urinalysis: A urine sample may be analyzed to rule out other possible causes of urinary symptoms.
Prostate-Specific Antigen (PSA) Test: A blood test may be performed to measure the PSA levels, which can help evaluate the risk of prostate cancer.
Urodynamic Testing: In some cases, urodynamic tests may be conducted to evaluate bladder function and urine flow.

Treatment Options for BPH

BPH Symptoms Diagnosis and Treatment There are several treatment options available to manage and treat BPH, depending on the severity of symptoms and the impact on the patient’s quality of life. Common treatment options include:

Watchful Waiting: In cases where symptoms are mild or not bothersome, a “watchful waiting” approach may be recommended, with regular monitoring of symptoms.
Lifestyle Changes: Certain lifestyle modifications, such as limiting fluid intake before bedtime, avoiding caffeine and alcohol, and practicing double voiding, may help alleviate symptoms.
Medications: Medications, such as alpha-blockers or 5-alpha reductase inhibitors, can help relax the prostate gland and improve urine flow.
Minimally Invasive Procedures: Minimally invasive procedures, like transurethral microwave therapy (TUMT) or prostate artery embolization (PAE), can help reduce the size of the prostate gland and relieve symptoms.
Surgery: In severe cases, surgical interventions such as transurethral resection of the prostate (TURP) or laser surgery may be recommended to remove or reduce the size of the prostate gland, thereby improving urinary flow.

Contact Fifth Avenue Urology for Expert Urological Treatment

If you are experiencing symptoms of Benign Prostatic Hyperplasia (BPH), the experienced urologists at Fifth Avenue Urology, led by Dr. Yaniv Larish, are here to help. We offer comprehensive urological care and a range of treatment options tailored to your specific needs.

Don’t let the symptoms of BPH limit your lifestyle or affect your well-being. Take the first step towards relief by contacting Fifth Avenue Urology today. Our team of skilled urologists will provide a thorough evaluation, diagnose your condition, and guide you through the available treatment options.

Regain control of your urinary health and improve your quality of life. Contact Fifth Avenue Urology now to schedule a consultation:

FIFTH AVENUE UROLOGY
5 East 83rd Street
New York, NY 10028
Phone: 212-675-3186
Website: https://www.fifthavenueurology.com/

What are the Symptoms of Benign Prostatic Hyperplasia (BPH)?

What is Benign Prostatic Hyperplasia and what are the symptoms of BPH? The prostate is a walnut-shaped gland present in front of the rectum and under the bladder. It comprises the urethra, which is the tube that carries semen and urine into the penis. Prostate glands cause mild to severe complications when they grow in size.

Symptoms of BPH

One of the main functions that the prostate glands perform is producing fluid that makes up the semen. This liquid is necessary to nourish and assist the transportation of sperm through the penis. When the prostate enlarges, there can be problems with the production of semen and possible complications when passing urine or ejaculating.

What Happens in BPH?

In Benign Prostatic Hyperplasia (BPH), the walnut shaped prostate enlarges and makes it difficult for the urethra to contract or expand when urinating or ejaculating. It is a non-cancerous prostate condition also called Benign Prostatic Enlargement (BPE).

What are the Symptoms of BPH?

As the muscular tissues and surrounding cells of the prostate grow and increase in size, you may experience multiple symptoms ranging from barely detectable to highly noticeable. One of the main things that you should keep in mind is that BPH can cause disruptions and block the tube (i.e., urethra).

These are the symptoms that a person might experience:

Urgency to urinate
Dribbling urinary system
Slow urination
Urination at night
Trouble starting urination
Pain during ejaculation or after urination
Pain while sitting (enlarge prostate)

Severe symptoms might include:

Bladder infections
Bladder stones
Blood in urine
Kidney damage from the pressure due to large amounts of urine retained in the bladder
Inability to urinate despite frequent urges
Pain/Fever/Chills associated with frequent urination
Lower abdomen pain
Genital Pain when urinating

Treatment Options for BPH

For mild cases, simple remedial solutions can help regulate the condition and prevent progression. However, waiting for the condition to resolve on its own due to mild symptoms doesn’t necessarily mean that it will happen. In fact, mild symptoms can progress into a chronic problem. Hence, proper treatment options are vital to take care of such a condition and maintain the health of prostate glands.

Medications

Medication can help control the growth of the prostate glands by inhibiting the abnormal production of the hormones responsible for it. Moreover, medication can also control the relaxation of the prostate glands, which may help in reducing the pressure on the urethra. Hence, it is possible to alleviate the symptoms of BPH through medication and control the frequent urges to urinate or improper urination.

However, you should know that certain medications can cause retrograde ejaculation and other related symptoms, including lightheadedness, weakness, and tiredness.

Surgery

Your doctor might suggest surgical procedures to remove the excess prostate tissue causing the enlargement and pressure on the urethra. These surgeries aim to remove the excess tissues completely through different surgical approaches.

Transurethral Incision of the Prostate (TUIP)

In this surgical procedure, the doctor will make two incisions towards the bladder neck and the prostate gland (enlarged). This is the area where the urethra and the bladder join. The procedure widens the urethra in order to assist urination.

Transurethral Electro-vaporization

This technique involves the use of electrical energy to heat the excess tissue on the prostate. This heat will convert the excess tissue in the process into steam.

Transurethral Resection of the Prostate (TURP)

Using special and fine instruments, your urologist will remove the excess tissue that blocks the urethra. The side effects might include infections, bleeding, or impotence (erectile dysfunction). However, it will free up the urethra from any physical tension and allow free urination.

Laser Treatments

The latest treatment options include the use of laser energy to target the tissue area that blocks the urethra.

Minimally Invasive Treatments

While medications and certain invasive surgical measures help treat BPH, there are more advancements in the medical procedures that can treat the problem effectively. Notably, minimally invasive medical procedures are cost-effective, carry minimal side effects, and allow speedy recovery.

Symptoms of BPH Benign Prostatic Hyperplasia

Water-Vapor Therapy

Water therapy involves the insertion of a special instrument into the penis towards the prostate gland. Following that, the doctor inserts a fine needle into the instrument that reaches the prostate gland and emits steam vapors. The steam converts to water on the prostate, which causes a transfer of thermal energy. Hence, the heat kills the excess tissue, and the body absorbs the dead cells.

Prostatic Urethral Lift

In this procedure, the doctor separates the lobes of the enlarged prostate(s) in order to ensure that the urethra remains wide. Thus, it is easier to urinate and control the function. Inserting an instrument into the penis and moving it forward, your doctor will transfer thin implants to the sides of the enlarged prostate. The pull from 2-6 transplants releases the tension on the urethra and makes it wider.

Symptoms of BPH: Conclusion

Do you require treatments for BPH conditions? Are there severe symptoms that require immediate medical attention? Well, you should get in touch with the experts at Fifth Avenue Urology. They can help you deal with the symptoms, decide on treatment plans, and ensure effective solutions to your urethral health conditions.

Ring us at 212-675-3186 for an appointment today. It is best to consult a urologist for your needs if you are facing even acute symptoms.

References

https://www.hopkinsmedicine.org/health/conditions-and-diseases/benign-prostatic-hyperplasia-bph
https://www.webmd.com/men/prostate-enlargement-bph/what-is-bph
https://www.healthline.com/health/enlarged-prostate
https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph)

What is Benign Prostate Hyperplasia (BPH)?

What is benign prostate hyperplasia (BPH)? We’ve outlined relevant details about BPH in this article, including common symptoms, causes, risk factors, diagnosis methods, and treatment options.

Benign prostate hyperplasia (BPH)

Benign prostate hyperplasia (BPH) implies a urological condition where the bladder becomes enlarged. BPH exclusively affects men aged 51-60 who experience a blockage in the smooth release of urine. Benign prostatic hyperplasia could also lead to renal (kidney), urinary tract, and urinary bladder issues.

A men prostrate grows to twice its original size during the early phase of puberty. The gland experiences a second growth phase when a man becomes 25, and it continues to develop consistently with age. An enlarging prostate creates pressure on the urethra, causing the latter to become narrowed or constricted.

The urinary bladder is unable to empty itself owing to urethral narrowing leading to the occurrence of BPH. The word ‘benign’ preceding prostatic hyperplasia implies that the condition is not cancerous. However, a man with BPH could always be vulnerable to cancer, not necessarily because he’s suffering from the former.

BPH Symptoms

As per our experience, the symptoms of BPH and their acuteness could vary from one individual to another. With time, the symptoms tend to deteriorate. The most common symptom is the urge to urinate frequently. Other usual symptoms of BPH comprise:

Nocturia or the increasing urge to urinate more often at night
Streamlined and intermittent urination, i.e., thin discharge that starts and stops time and again
Finding it difficult to urinate
Trickling after urination
Experiencing difficulty in emptying the bladder

The less common symptoms include:

Hematuria (blood in urine)
Urinary tract infection (UTI)

Causes

bph-symptonms-treatment-options-nyc-specialists-02 BPH tends to be idiopathic; researchers are yet to pinpoint the exact cause or causes behind the condition. The functioning of the testes and aging are generally regarded as the chief causative factors of benign prostate hyperplasia. The fact that men whose testes were surgically excised before they attained adolescence do not develop BPH lends credence to the above postulations.

As men grow older, the production of male hormone testosterone decreases, which tilts the balance in favor of estrogen. Incidentally, men also produce a small proportion of the female sex hormone estrogen. This imbalance leads to a proliferation of substances that trigger the incidence of BPH.

A large number of medical experts also feel that increased levels of DHT (dihydrotestosterone) could also cause BPH. Other potential causes of BPH are:

Bladder or prostate cancer
Kidney or bladder stones
Urethral stricture (narrowing)
Prostatitis
UTI

Complications or risk factors of BPH

The likely complications of benign prostate hypertrophy are:

Kidney damage
Bladder damage
Bladder stones
UTIs
Urinary retention (the inability to empty the bladder)

The possible risk factors comprise

Obesity
Heart disease
Diabetes
Genetic predisposition
Aging

Diagnosis

Our urologists review patients’ medical history and analyze the symptoms and perform one or more of the following assays for confirming BPH:

PSA
Urinalysis
Urinary blood exam
Physical exam
Digital rectal exam (DRE)
Prostate ultrasound
Urodynamic pressure test
Cystoscopy

We also carry out another diagnostic test for establishing whether a patient has BPH.

Treatment

We offer a range of treatment options at Fifth Avenue to BPH patients, including medicines (alpha blockers and alpha reductase inhibitors), self-catheterization, surgical procedures, and lifestyle changes.

Schedule a Confidential Consultation Today

Our urologists at Fifth Avenue Urology, Drs. Michael Brodherson, Leonard Glickman, and Yaniv Larish provide exemplary urological care. We’re fully conversant with the issues involving the human urological system, starting from the kidneys up to the reproductive system. At the same time, we’re aware of the physical and psychological aspects of urological conditions.

We treat all urological issues. The urological services we proffer comprise treatment for prostatitis, incontinence, kidney, prostate, testicular, and bladder cancers, vasectomy, circumcision, and BPH.

Talking about BPH, we regularly offer consultation and treatment to men in their fifties and sixties with an enlarged prostate.

FIFTH AVENUE UROLOGY
——–
5 East 83rd Street
New York, NY 10028
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212-675-3186

References

Benign Prostatic Hyperplasia (BPH) – Enlarged Prostate

Do you suffer from an enlarged prostate also known as benign prostatic hyperplasia? Also known as BPH, this is somewhat of a common condition and one that should involve a consultation and treatment with your doctor. The prostate gland is located around the urethra. This is the tube that moves urine from your bladder out of your body. In some situations, this gland can get larger. When this happens, it puts pressure on the urethra and even blocks it. This can create problems for men during urination.

What Causes BPH?

Benign Prostatic Hyperplasia–Enlarged Prostate

There are various causes of this condition and one of the first things your doctor will do is to determine what the cause is if possible. It’s important to know that this is generally a normal part of the aging process. It is brought on, in most cases, by changes in hormones that are flowing through the body and in cell growth. For many men, it just happens as they get older.

What Can BPH Cause in Men?

Though the condition will impact men in different ways, it is likely to cause some of the following circumstances:
It can make it harder for men to get a urine stream started. In addition to this, it can also be harder for men to completely stop urinating. They may dribble.

It can create a weak stream of urine.
Men may feel the need to urinate more often. This may even cause them to wake up in the middle of the night.
You may feel as though your bladder is not fully empty even after urinating.

enlargedprostate2 In some cases, this condition can cause the bladder to become blocked. This makes it very difficult or even impossible for men to urinate. When this happens, it creates a backup that can damage the kidneys, create bladder stones or lead to bladder infections. That’s why it is important for men to seek out treatment from their doctors should they believe that they have this condition.

If you believe you may be suffering from BPH or an enlarged prostate, talk to your doctor about your symptoms. It is important to notice and take action to treat this condition if present to prevent it from worsening and leading to complications in urinary system health.

Learn more about your condition and contact the leading NYC urologists today at 212-675-3186.

What is Benign Prostatic Hyperplasia?

enlargedprostate The prostate is an organ that is well known for being a source of problems for men, particularly as they age. Benign prostatic hyperplasia, also known as benign prostatic hypertrophy (or BPH for short), is one of the most common prostate problems, and affects as many as 50% of men over 75, though it can occur in younger men too.

Here, we take a look at what BPH is, the symptoms it can cause, and what can be done if you are experiencing them:

Benign Prostatic Hyperplasia

BPH is a condition where the prostate gland is enlarged. Because the prostate surrounds the urethra, the tube which carries urine from the bladder and out of the body, enlargement can restrict the urethra and cause urinary difficulties.

As you might expect from the word ‘benign’ in the name, BPH is not prostate cancer, or anything else threatening or serious. However, it can be an uncomfortable condition to live with.

Symptoms Associated with BPH

An enlarged prostate can cause a number of symptoms, which are generally annoying and uncomfortable. Men with BPH may feel the need to urinate more often, but have trouble getting started or maintaining a normal urine stream. They may also feel the need to urinate immediately after finishing. BPH also tends to make patients need to urinate more often, a sensation which can wake them up frequently at night.

BPH can also, in rarer cases, cause urine retention. This is where urine remains in the bladder longer than it should, which can lead to bladder stones and other complications.

Prevention and Treatment

Sadly, there is no known way to prevent BPH, which is seen as a normal part of aging in males. There is also no permanent cure, though there are self help techniques to help you live more comfortably with BPH, as well as medical options that can help you reduce the symptoms you experience. It is also wise if you have BPH to avoid certain medications like some over the counter antihistamines and decongestants, which have been shown to exacerbate problems with urination.

If you are concerned about your prostate health, it is always best to make an appointment to see us, because while BPH is not a dangerous or serious condition, other prostate problems can be. If you need help controlling BPH, or have any other prostate concerns, please contact us today at 212-675-3186!

Benign Prostatic Hyperplasia–Enlarged Prostate

What Causes BPH?

What Can BPH Cause in Men?

Though the condition will impact men in different ways, it is likely to cause some of the following circumstances:

It can make it harder for men to get a urine stream started. In addition to this, it can also be harder for men to completely stop urinating. They may dribble.
It can create a weak stream of urine.
Men may feel the need to urinate more often. This may even cause them to wake up in the middle of the night.
You may feel as though your bladder is not fully empty even after urinating.

Benign Prostatic Hyperplasia In some cases, this condition can cause the bladder to become blocked. This makes it very difficult or even impossible for men to urinate. When this happens, it creates a backup that can damage the kidneys, create bladder stones or lead to bladder infections. That’s why it is important for men to seek out treatment from their doctors should they believe that they have this condition.

BPH – Benign Prostatic Hyperplasia–Enlarged Prostate

The symptoms of BPH are the reason why most men come to a Urologist’s office for help. So, what is BPH, and what do the letters represent?

The B stands for benign that is, a non-cancerous condition that can make you miserable but not kill you.

The P stands for prostate, the gland in front of the bladder through which we urinate. The prostate makes secretions that comprises about one half of the ejaculate during orgasm.

The H stands for hyperplasia, a condition in which the cells of an organ reproduce more than normal cells that are present and the organ gets larger.

BPH is very common symptomatically affecting more than 50% of men in their 60’s and the problem increases with aging. It is much more common problem than prostate cancer (it is present in 80% of men aged 70 to 79) but both can exist at the same time.

What happens when the prostate gland enlarges is that makes it harder for men to urinate. It becomes harder to start the stream. The stream becomes slower and weaker so that it takes longer to empty a full bladder. The stream may become so weak that the bladder does not empty properly. That starts a secondary effect because the bladder is left full and there is an increased need to empty a partially full bladder.

The problem is day and night so that sleep becomes interrupted to go to the bathroom to void at night. That doesn’t bother some men, but other men who cannot go back to sleep are miserable. As the bladder begins to fight the obstruction of the prostate it may become irritable and cause urinary urgency and when really profound, cause urge incontinence; a problem that can cause the man to “pee in his pants’ if a bathroom is not nearby. That can be a problem in a car stranded in a traffic jam or on the street when there are no public rest rooms.

I have highlighted the word bother: that will determine if and when treatment is needed. When men are bothered to the point of distraction by those symptoms, they need treatment. Those who are not (“It doesn’t bother me to wake up 4 times a night; I go right back to sleep.”) do not need treatment.

Some men absolutely need treatment for BPH even if they have minimal symptoms. Who are they?

1. Men who cannot empty their bladder or who retain more than 10 ounces of urine in the bladder; they must be treated. Not being able to pee at all is painful and dangerous and an obvious reason for treatment. Men who retain larger and larger amounts of urine in the bladder may block the egress of urine form the kidneys and have kidney failure so they need to be treated to keep the kidneys healthy. Also if the bladder is overly distended for long periods of time it may become scarred and even if the prostate is treated may not be capable of emptying properly.

2. Men who develop bladder stones because they do not empty urine from the bladder as a result of their BPH need treatment.

3. Men who have repeated obviously bloody urine as a result their large prostate need treatment.

4. Men who develop repeated bladder infections because of the BPH need treatment.

The treatments for BPH have changed dramatically over the past few decades. I will review those new therapies in the next blog.

For a consultation with the Dr. Melman about BPH, or any other urology related problems, call today!