What is BPH?
BPH stands for benign prostatic hyperplasia, the medical term for an enlarged prostate. It involves prostate tissue response to testosterone and occurs normally in all men. All BPH does not require therapy.
How is BPH treated?
There is no cure for BPH, but once treatment is started, growth is generally halted. Due to different ways BPH affects the individual, there are multiple types of treatment. Frequently, minimally invasive treatments will suffice.
What are the different kinds of treatment?
Alpha-adrenergic receptor blockers, such as Hytrin®, Cardura®, Flomax® and RAPAFLO®, relax muscles around blood vessels within the prostate and bladder. This increases urinary flow and relieves urinary frequency and nocturia.
Side effects may include dizziness, fatigue and headaches. Flomax, since it focuses more on the prostate, has fewer side effects than Hytrin or Cardura.
5-alpha reductas inhibitors, such as Proscar® (finasteride) and Avodart, obstructs the conversion of testosterone to dihydrotestosterone. This causes the prostate to shrink in size, thus reducing the BPH symptoms and increasing urinary flow rates. Possible
side effects include impotence, decreased libido and decreased volume of ejaculate.
Herbal medications have become popular recently. The most commonly used herbal treatment is Saw palmetto. Since this is an anti-inflammatory, it reduces the swelling of the prostate. Limited studies have been performed to test its effectiveness.
Minimally Invasive Procedures
The Prolieve® System is a medical device that can be used in-office to both heat the prostate and dilate the prostatic urethra to treat the symptoms of BPH.
During treatment, your physician will insert a catheter into your urethra, which will circulate water throughout the procedure. Microwave energy will be transmitted to a special antenna inside the catheter, heating the prostate and reducing the enlarged tissue.
The procedure only takes 45 minutes. Side effects with the Prolieve System may include anal irritation, bleeding, bowel irritation, bladder spasms, urinary tract infection, urinary incontinence, retrograde ejaculation, pressure sensation, prostatitis, urethral irritation, erectile dysfunction, urinary clot retention, chronic pain at the procedure site, urinary urgency and complete or incomplete urinary retention.
Prostiva RF Therapy, formerly known as transurethral needle ablation of the prostate (TUNA), heats the enlarged, inner part of the prostate to very high temperatures, shrinking the prostate and opening the urinary channel. The device used to perform this procedure is computer-controlled and uses radiofrequency energy to generate heat.
Prostiva therapy may be performed in-office and usually takes only 30 to 60 minutes.
Side effects include decreased volume of ejaculate, urinary retention, urinary infection, burning with urination, frequent urination and a slower urinary stream.
Transurethral resection of the prostate (TURP) is the most common surgery to remove part of an enlarged prostate. During the procedure, an instrument is inserted up the urethra to remove the section of the prostate blocking urine flow. This is done using general or spinal anesthetic and commonly requires staying in the hospital for a day or two. Constipation, sexual activity and strenuous activity should be avoided for at least six weeks following the procedure. Side effects may include incontinence, problems with sexual performance and problems from surgery.
Holmium laser enulcleation of the prostate (HoLEP): Advanced laser surgery for severely enlarged prostates that avoids a more invasive, bigger prostate operation.
GreenLight™ Laser Therapy is a BPH treatment option that combines the effectiveness of TURP with fewer side effects. The procedure evaporates the prostatic tissue blocking the outlet of the bladder. GreenLight is generally performed under anesthesia as an outpatient procedure.
During the procedure, a telescope is inserted into the urethra up to the prostate. A laser fiber is then guided through the scope, gently vaporizing the prostate tissue.
GreenLight is known for providing impressive improvements in urine flow and a speedy return to normal activities. Side effects may include retrograde ejaculation, impotence, incontinence and scar tissue in the urethra.