Benign Prostatic Hyperplasia, also known as BPH, is an enlarged prostate that commonly causes urinary problems in men over the age of 50. It is a common condition that occurs as men age, causing the gland to press against the urethra and cause problems with urination.
After BPH is diagnosed, a treatment plan is created based on the patient’s specific condition.
Treatment of Benign Prostatic Hyperplasia
Treatment for benign prostatic hyperplasia may vary depending on the severity of the condition. There are various treatment options available for this condition.
Monitoring
Patients with mild symptoms may only need to monitor their condition for signs that it is worsening, while more severe cases may require medication to inhibit hormone production or relax the muscle in the prostate.
Medication
Two common types of medication for benign prostatic hyperplasia are:
Alpha Blockers
Alpha blockers relax the muscles in the bladder and prostate. They can help improve urine flow and reduce risk of bladder obstruction. They are often prescribed to men with smaller prostates.
5-Alpha Reductase Inhibitors
5-alpha reductase inhibitors block the male hormone that stimulates the prostate. These drugs are generally prescribed to men with significantly enlarged prostates or severe cases of benign prostatic hyperplasia. In addition to relieving symptoms, they increase urinary flow and may even help shrink the prostate.
Surgery
In some cases, surgery may be required to remove the prostate tissue that is blocking the flow of urine. There are several different surgical procedures available for treating benign prostatic hyperplasia, including:
Urolift
Urolift is a minimally invasive transurethral prostate procedure which uses pins to lift the prostate tissue out of the urethra. The number of clips placed depends on the anatomy of the prostate.
Transurethral Surgery
Transurethral resection of the prostate is a surgery with no external incisions. A modified cystoscope called a resectoscope is inserted through the urethra and uses an electrical wire loop that cuts tissue away from the center of the enlarged prostate.
Urethral Stent
A wire mesh stent is placed in the urethra within the prostate to hold the urethra open to allow the passage of urine. This is usually an option for patients who are unable to take medication or do not want to undergo more invasive surgery.
Transurethral Needle Ablation
With transurethral needle ablation, or TUNA, needles are inserted in the prostate and emit low-level frequency radio waves that create a heat that destroys the prostate tissue. The TUNA procedure utilizes high-frequency radio waves to destroy the superfluous tissue of the prostate gland. Needles are inserted into the enlarged areas of the prostate gland and send high-frequency radio waves, which will destroy the tissue around the needles. This reduces pressure on the urethra, and therefore decrease urinary difficulties.
Transurethral Microwave Thermotherapy
Transurethral microwave thermotherapy, also known as TUMT, uses high-frequency radio waves to cause injury to the prostate and provides relief for bladder obstruction. The surgeon utilizes a special catheter, called an antenna, that is inserted through the urethra to a location inside the prostate. Microwave energy is then used to heat the inside of the prostate while cooling fluid is circulated around the microwave antenna to prevent heat from damaging the wall of the urethra. As the damaged prostate tissue heals, it shrinks significantly, reducing the blockage of urine flow.
Transurethral Vaporization of the Prostate
During transurethral vaporization of the prostate, also known as TUVP, an elecrode transmits a current that vaporizes prostate tissue. Using an instrument that delivers high-voltage electrical current, the doctor pinpoints the prostrate tissue that will be destroyed.
Open Surgery
In the case of a significantly enlarged prostate, open surgery is usually recommended. An incision is made in the lower abdomen and the interior of the prostate is removed, leaving the outer lining of compressed normal prostate tissue. This surgery results in the greatest increase in urinary flow of all treatment techniques.
Surgery for benign prostatic hyperplasia usually provides effective results for at least fifteen years. Patients should continue to have rectal and prostate exams once a year and should see their doctor at the first sign of recurring symptoms.
There are a wide range of treatment options available for benign prostatic hyperplasia and if treated promptly and effectively, patients can live relatively normal lives.