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Considerations for managing enlarged prostate symptoms (BPH) during the COVID‑19 pandemic



Lower urinary tract symptoms (LUTS) can result from a common condition called benign prostatic hyperplasia (BPH) also known as enlarged prostate.

This is a non-cancerous enlargement of the prostate that progresses as men get older.
Symptoms may include waking up at night to urinate, a frequent need to urinate both day and night, or a weak or slow stream. These symptoms can be very bothersome and can negatively impact a man’s quality of life.

If you have these symptoms or have been diagnosed with BPH, there may be steps you can take to learn more about treatment options and gain some relief, despite the restrictions currently in place due to the Coronavirus (COVID-19) pandemic.

What BPH patients can do while access to in-office, non-emergency healthcare is limited

While our nation is in the midst of this unprecedented situation, we have been asked to maintain social distancing to limit the spread of the COVID-19 virus. And we must also preserve our valuable health care resources for the sickest and most vulnerable patients who need them the most.

For this reason, the Centers for Medicare and Medicaid Services (CMS) and the American College of Surgeons (ACS) have recently issued recommendations postponing non-emergency procedures. This may include- procedures to treat enlarged prostate, such as the UroLift® System, which is a minimally invasive treatment option for BPH.

In the meantime, here are some steps patients and undiagnosed symptom sufferers can take:

1. Understand the Facts about BPH

Because of the limited access to health care providers, it is important to understand the facts about BPH and maintain proper perspective while we await normal office hours to resume so men can receive an appropriate diagnosis and treatment of BPH symptoms.

Here is some good news about BPH: in most cases, the condition progresses slowly. Over the long-term, if BPH is left untreated the condition can worsen and cause permanent bladder damage.1 However, in the short-term, it is primarily a quality of life issue.

2. Take the IPSS Questionnaire and get your score to determine your next steps

First, research symptoms and treatment options online. Then, complete the International Prostate Symptom Score (IPSS) questionnaire online to measure the severity of your BPH symptoms. Your score is not meant to provide medical advice or replace your doctor's expert opinion and care, however, may provide additional insight into the severity of your symptoms. Your score may help you determine whether you should follow-up with a urologist to undergo further assessment and how urgently you should take that action when access to care improves.

3. Ask your doctor for a telemedicine visit by phone/video

Fortunately, many physicians are available to see patients for medical assessment and treatment via telemedicine.** Share the results of your IPSS score with your provider and discuss your symptoms. Your doctor may provide helpful advice about appropriate lifestyle and dietary modifications that may help improve your urinary symptoms.

You may also be given a prescription medication to help manage bothersome symptoms in the short-term. And you will be able to discuss when you can be seen in person.

A note on medication as a long-term treatment option

Over time, many men discontinue use of BPH drugs as prescribed because they may not work well2 or may cause significant side effects.4 Over the long term, drug therapy may not reliably protect the bladder from damage due to progression of BPH.

The UroLift® System has demonstrated greater symptom relief that reported for medications3,4 and can avoid drug side effects such as sexual dysfunction*3, dizziness and headaches. In order to preserve bladder health, it has been shown that it is better to effectively treat BPH than not to treat.1

Looking forward

The pandemic and resulting challenges will pass. How soon, we do not know, but it is important to follow the guidelines for social distancing set forth by medical experts to limit the scope and duration of this crisis.

When in-office and elective procedures become available again, many BPH patients will have more options for long-term treatment and relief of symptoms.  Stay in touch with your physicians for the next right steps.

On a personal note, I urge everyone to be patient and supportive with one another.  Healthcare is about more than tests, procedures, and medications.  There has been a sharp increase in the number of Americans who say their emotional well-being has declined in the past few weeks.5 Reaching out, albeit through phone or other technology, and offering help where we can to those who need additional support is more critical now than ever.  It is a great paradox that at a time when we need to socially distance, we must be more socially connected than ever.

Take care and be well.

Peter Walter, M.D., F.A.C.S

Dr. Walter is a board-certified urologist practicing in Jamestown, NY, and paid faculty member at NeoTract. This blog is hosted on a NeoTract branded site (www.UroLift.com).

1 Tubaro et al. 2003 Drugs Aging
2 AUA BPH Guidelines 2003, 2010, 2018
3 Roehrborn J Urol 2013 LIFT Study
4 AUA BPH Guidelines 2003
5 Tumolo, J. (2020, March 20). Poll: COVID-19 Affecting Mental Health of Many Americans. Psychiatry & Behavioral Health Learning Network. https://www.psychcongress.com/article/poll-covid-19-affecting-mental-health-many-americans

*NeoTract, Inc. is not responsible and cannot be held liable for the reliability of any telemedicine consultations with urologists. Depending upon your individual circumstances and location, urologists may or may not offer such telemedicine consultations.  Accordingly, state specific coverage of telemedicine consultations differs as well.

**No instances of new, sustained erectile or ejaculatory dysfunction in the LIFT pivotal study, Roehrborn 2013


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