BPH Treatment Guidelines

Benign prostatic hyperplasia (BPH) is more commonly known as an enlarged prostate. Many men experience this condition starting in their 40s. As the prostate grows, it presses on the urethra and interferes with proper urine flow. Treatment will depend on various factors. This condition is not linked with prostate cancer.

General Treatment Information

• The type of treatment you receive depends on the size of your prostate and the severity of your symptoms. If you have serious problems like blood in the urine, recurrent urinary tract infections or bladder and kidney damage, you will most likely require some sort of treatment. If symptoms are mild or non-existent, you might not require any medical intervention. Treatments include medications, surgery and non-surgical therapies

Controlling Symptoms

• Several self-care methods can help you control symptoms on your own. Avoid drinking anything one to two hours before going to bed. Cut back on caffeine and alcohol; they irritate the bladder and increase urination. Do not use decongestants and antihistamine medications; they constrict the group of muscles around the urethra, making it harder to release urine. Go to the bathroom when the urge strikes; holding it in can stretch the bladder muscle. Exercise on a regular basis to encourage urination. Stay warm. When you are cold, you are more likely to retain urine and experience an urgency to urinate.

Medications

• If your symptoms are moderate, certain medications can address your BPH. Alpha blockers increase ease of urination by relaxing bladder muscles. Commonly prescribed drugs include Hytrin, Cardura, Flomax and Uroxatral. These medications take effect within a day or two. Discuss these treatments with your doctor if you take drugs for erectile dysfunction; their interaction can lower blood pressure.

  Enzyme inhibitors reduce the size of your prostate gland. They do not work as well if your prostate is only moderately enlarged or normal-sized. These drugs do not work as quickly as alpha blockers and can take a few months before you notice reduced symptoms. Proscar and Avodart are used for BPH.

  In some cases, your doctor might give you a combination therapy.

Non-Invasive Treatment

• The following non-surgical treatments shrink the prostate and enlarge the urethra. These procedures are not appropriate for men who have an unusually large or abnormally shaped prostate. Microwave therapy, transurethral needle ablation (TUNA) and interstitial laser therapy (ILT) use various forms of heat to destroy the overgrown prostate tissue.

  Prostatic stents keep the urethra open. Tissue that grows over it keeps it in place. They are not considered a good choice for long-term relief and are usually used on men who either refuse or cannot take medications or undergo surgery. The stents can give quick relief of urine blockage but might not provide long-term symptom relief.

Surgical Procedures

• Surgical procedures are the best option if you have an unusually large prostate that cannot be treated by other means or if you have complications like frequent infections. Most procedures involve going up the urethra and destroying a portion of the enlarged prostate. If your prostate is especially large or if you have bladder damage, you will need an open prostatectomy, which requires the surgeon to make an incision in your abdomen. He then removes the inner portion of your prostate.

  These procedures are more involved than non-surgical ones and you might need to stay in the hospital for a few days and hold off on certain activities for a couple of weeks. Your doctor will advise you about these matters.