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BPH Prostate Treatment

Along with death and taxes, males who live to old age might have to add another certainty in life--benign prostatic hyperplasia (BPH). Defined simply as prostate enlargement, BPH is the non-cancerous overgrowth of cells in the prostate gland. Often leading to a wide range of physical symptoms, including urinary problems, bladder stones, and incontinence, the chronic, progressive disease can be managed by a variety of treatments.

  1. Watchful Waiting

    • Despite its name, watchful waiting does not mean to simply wait and do nothing about BPH. Lifestyle changes, including changing fluid intake, diet and regular emptying of the bladder, sometimes are enough to alleviate symptoms of the condition. Patients defer medical treatment but are regularly monitored and are treated should the condition worsen.

    Medical Treatments

    • Medication is typically the first option. Alpha blockers such as doxazosin, terazosin, tamsulosin and alfuzosin relax the prostate. Side effects of these drugs include fatigue, headaches, nasal congestion and dizziness.

      Equally as effective as alpha blockers, finasteride and dutasteride were approved for the treatment of BPH in 1996. Finasteride can cause a loss of libido and erectile dysfunction in three to four percent of patients. However, it has proven to be highly effective in halting BPH and in reducing the need for surgery down the line. A study called the Prostate Cancer Prevention Trial indicated that finasteride may even prevent prostate cancer.

    Herbal Treatments

    • Phytotherapy is an alternative treatment with herbal supplements. The therapy is unregulated, expensive and unproven.

      A small percentage of patients report that saw palmetto is effective in managing the symptoms of BPH. While scientific proof is not as yet forthcoming, there is no harm in trying out this natural agent.

    Surgical Treatment

    • If symptoms worsen and affect normal activities while the patient is on medication, surgery should be considered to remove all of the excess prostate tissue. Transurethral resection of the prostate (TURP), often referred to as the Roto-Rooter surgery, is the top surgical procedure for BHP. Although it results in infertility, other side effects are minimal.

      For larger prostates, an open prostatectomy is sometimes suggested. An incision is made through the abdomen to remove excess prostate tissue. Ejaculation problems and erectile dysfunction are common side effects of this procedure.

      Transurethral electrovaporization of the prostate (TUVP) heats and vaporizes the overgrowth with minimal side effects.

      Laser prostatectomy relieves urinary symptoms by cooking and vaporizing the excess prostate tissue. Results are comparable to TURP.

    Other Surgery

    • For small prostates, surgical procedures have been designed to improve symptoms without removing all of the BPH. Transurethral incision of the prostate (TUIP), transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), and high-intensity yltrasound (HIFU) are options to be considered. In the short term, urinary incontinence, ejaculation problems, and sexual dysfunction may be anticipated. Long-term effects have yet to be fully researched.

    Stents

    • A prostatic stent is a mechanical device which helps urinary problems and voiding issues. A metal mesh apparatus is inserted into the urethra and prostate, keeping the channel open. Usually this procedure is confined to elderly patients or men with additional serious medical conditions.

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