The prostate is a walnut-sized gland that surrounds the urethra (the tube used to urinate). As men age, the prostate gland keeps growing causing urinary problems. Symptoms of prostate enlargement include slowing of the urinary stream, urinary frequency, hesitancy, and occasional urinary leakage. Enlarged prostate, also known as BPH (benign prostatic hyperplasia), affects half of men over the age of 50 and up to 90% of men over 80. So, the older you get, the higher your chances of having related problems.
But we have good news! There are several treatment options available for an enlarged prostate. At KCUC, we stay on the cutting edge of urological treatments and we offer the latest options. You and your doctor will decide which one is best for your specific diagnosis, but read on to learn more about what’s available.
Non-Surgical Treatment Options for Enlarged Prostate (BPH)
If suggested lifestyle changes aren’t working (reducing the intake of caffeine, acidic drinks, alcohol, antihistamines or pseudoephedrine), medication is the first step in treating an enlarged prostate. It is the least invasive form of treatment. Medications may include:
- Alpha blockers to relax the smooth muscle tissue in the bladder neck and prostate, increasing urinary flow (examples are tamsulosin and doxazosin)
- Five alpha reductase inhibitors which shrink the prostate by preventing the conversion of testosterone to dihydrotestosterone, a testosterone metabolite which can cause prostate enlargement
- Antispasmodics (bladder relaxant) to reduce frequency and urgency
Some men respond well to medication. Others don’t find the relief they are looking for or, as they age, the prostate continues to grow and causes more severe issues that the medicine cannot counteract. If medication is ineffective, patients can move on to other treatment options.
Rezūm is a minimally invasive procedure that uses hot steam to reduce the enlarged part of the prostate responsible for urinary obstruction. Steam denatures the protein structure of the enlarged prostate causing it to shrink away from the urethra, thus relieving the blockage. This treatment minimizes the negative effect on surrounding tissue so it preserves sexual and urinary functions so patients can quickly resume normal activities.
With UroLift, permanent implants hold the prostate tissue away from the urethra so urine can flow freely. The UroLift procedure requires no cutting, heating or tissue removal. It’s a simple mechanical answer to a mechanical problem. UroLift avoids erectile and ejaculatory dysfunction. This procedure is best for those with moderate-sized prostate glands. It is less well suited to those with very large glands, small glands, or median lobes (prostate extension into the bladder).
Aquablation therapy is an advanced, minimally invasive treatment for BPH that uses imaging, robotics, and a heat-free water jet. This newer treatment offers several advantages. First, by using two types of imaging, the surgeon can see the entire prostate. Additionally, robotics and advanced computer software allow the surgeon to create a personalized treatment plan before surgery begins. Finally, the heat-free water jet allows the surgeon to remove the excess prostate tissue precisely and more safely than with other methods that use heat. It is precise, consistent, and predictable, and provides long-term relief no matter how large the prostate. All of these advantages combined result in fewer post-procedure side effects. Most men retain urination, erection, and ejaculation function.
Surgical Treatment Options for Enlarged Prostate (BPH)
Transurethral Resection of the Prostate
Transurethral Resection of the Prostate or TURP is an endoscopic (performed with a scope) procedure in which the urinary channel through the prostate is enlarged by removing obstructing prostate tissue adjacent to the urethra. The urethral lining is removed with the prostate tissue but regenerates within six to eight weeks. There are generally two types of TURPs performed:
- Traditional TURP: a scope is inserted into the urinary channel and the obstructing prostatic tissue is removed with an electric cutting instrument.
- LASER TURP: a scope is inserted through the urinary channel and the obstructing prostatic tissue is removed (ablated) with a LASER.
Transurethral Incision of the Prostate
Transurethral Incision of the Prostate or TUIP is an endoscopic procedure in which a resectoscope is inserted through the urinary channel and the doctor cuts one or two small grooves in the area where the prostate and bladder are connected to widen the urinary channel.
All of these procedures are performed with the patient under anesthesia in the hospital operating room. They are well established with an overall up to 80% rate of improvement in urinary symptoms.
A prostatectomy is an open procedure to remove the obstructing prostate. This procedure is rarely done and reserved for those with very large prostates.
If you are suffering from BPH symptoms, don’t hesitate to contact one of the urologists at KCUC. We can help you choose a treatment regimen that’s right for you and get you the relief you need.