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Benign Prostatic Hyperplasia (BPH) - Enlarged Prostate
Treatment Options
If you are diagnosed with Benign Prostatic Hyperplasia, your doctor will discuss treatment options with you. For a man with a prostate only slightly enlarged and who is experiencing no irritative symptoms, "watchful waiting" could be an option. Drug therapy, surgery, microwave, and laser therapies are all options to consider for men whose symptoms warrant treatment.
[drug treatments] [surgical treatments] [laser therapy]
Drug Therapy
Drug treatments last a lifetime. Men who choose drug therapy must be prepared for the cost of the drugs as well as the daily regimen. There are potential side effects to the drugs that your doctor will discuss with you. Over time, the drugs may lose their effectiveness in relieving your symptoms. At this time there are four main drugs that are used to relieve prostrate enlargement symptoms:
Finasteride (Proscar®) shrinks the prostate by fighting the production
of the hormone that is involved with prostate enlargement. Although side
effects are less severe than with other types of drugs, decreased libido
and impotence are possible. This drug may take several months to be effective.
Terazosin (Hytrin®), Doxazosin (Cardura®), and Tamsulosin
(Flomax®)are alpha-blockers which are also used to treat high blood
pressure. These drugs work by relaxing the smooth muscles in the prostate
and neck of the bladder. Relief from BPH symptoms occurs quickly as bladder
obstruction lessens and urine flow is improved. Possible side effects of
these drugs may include dizziness and fatigue, and rarely impotence.
Because drug therapy is not always effective, surgery remains a commonly recommended long-range solution for BPH. Urine is able to flow again when the excess tissue pressing against the urethra is removed. There are two common types of surgeries used to treat BPH: transurethral resection of the prostate (TURP) and transurethral incision of the prostate (TIRP). Side effects vary with each patient. Risks include possible difficulty in attaining erections, ejaculation problems, or incontinence and bleeding requiring transfusion.
TURP - There is a
greater relief of symptoms with TURP than with drug therapies, but the
risks of impotence and incontinence are more significant. No external incision
is necessary with the TURP procedure, and it is performed under anesthesia.
Recovery time is shorter than with open forms of surgery.
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The surgeon inserts an instrument called a resectoscope through the penis. This instrument has a light, valves for controlling irrigating fluid, and an electrical loop. The surgeon uses this loop to cut the obstructing tissue a piece at a time, and blood vessels are sealed. The irrigation fluid carries the tissue to the bladder, where the surgeon can flush it out at the end of the procedure. |
TUIP - In this procedure, prostate tissue is left intact. Instead
of removing prostate tissue, your surgeon makes small incisions in the
prostate and the neck of the bladder where the urethra connects. This widens
the urethra so that urine can flow more easily.
In some cases your surgeon may choose to remove the excess tissue
through an abdominal incision. This is indicated with greatly enlarged
prostates, when there are complicating factors, or when a damaged bladder
requires repair.
Using a direct telescopic view, the doctor uses a diode laser to heat a precise area of the enlarged prostate. This destroys the tissue, which is then absorbed naturally by the body. As the tissue is absorbed, symptoms begin to improve over time. Side effects such as incontinence and retrograde ejaculation are less likely to occur than with surgical treatments for BPH. Laser surgery is done as an out patient. Laser surgery offers another advantage in that no tissue is cut. Compared to traditional surgery, there is less postoperative bleeding with laser therapy.
[BPH] [BPH Treatment Options] [BPH - Recovering from Prostate Surgery]
[Index] [Dr. Padron]
[Vasectomy Reversal] [Male Infertility] [Varicocele]
[BPH - Enlarged Prostate] [Prostate Cancer] [Incontinence]
[Glossary] [Offices, Insurance, and Payment Information] [Links]
Dr. Padron's web site is designed for educational purposes.
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Please consult your health care provider if you have or suspect you have a health problem.
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