If trips to the restroom require sudden dashes or are marked by
difficulty urinating, your prostate may be enlarged. You’re not
alone the Urology Care Foundation estimates that 50 percent of men
in their 50s have an enlarged prostate. The prostate is the gland
that produces the fluid that carries sperm. It grows larger with
age. An enlarged prostate, or benign prostatic hyperplasia (BPH),
can block the urethra from transporting urine from the bladder and
out of the penis.
Keep reading to learn about traditional treatments for BPH.
BPH treatment options
Don’t resign yourself to living with BPH. Addressing your symptoms
now can help you avoid problems later. Untreated BPH may lead to
urinary tract infections, acute urinary retention (you can’t go at
all), and kidney and bladder stones. In severe cases it can lead to
kidney damage.
Treatment options include medications and surgery. You and your
doctor will consider several factors when you evaluate these
choices.
These factors include:
how much your symptoms interfere with your life
the size of your prostate
your age
your overall health
any other medical conditions
Alpha blockers for BPH
This class of
medications works by relaxing the bladder neck muscles and the
muscle fibers in the prostate. The muscle relaxation makes it easier
to urinate. You can expect an increase in urine flow and a less
frequent need to urinate within a day or two if you take an alpha
blocker for BPH. Alpha blockers include:
This type of medication reduces the size of the prostate gland by
blocking hormones that spur the growth of your prostate gland.
Dutasteride (Avodart) and finasteride (Proscar) are two types of
5-alpha reductase inhibitors. You’ll generally have to wait three to
six months for symptom relief with 5-alpha reductase inhibitors.
Medication combo
Taking a combination of an alpha blocker and a 5-alpha reductase
inhibitor provides greater symptom relief than taking either one of
these drugs alone, according to an article in Current Drug Targets.
Combination therapy is often recommended when an alpha blocker or
5-alpha reductase inhibitor isn’t working on its own. Common
combinations that doctors prescribe are finasteride and doxazosin or
dutasteride and tamsulosin (Jalyn). The dutasteride and tamsulosin
combination comes as two drugs combined into a single tablet.
Stand the heat
There are minimally invasive surgery options when drug therapy isn’t
enough to relieve BPH symptoms. These procedures include
transurethral microwave thermotherapy (TUMT). Microwaves destroy
prostate tissue with heat during this outpatient procedure.
TUMT will not cure BPH. The procedure does cut down urinary
frequency, makes it easier to urinate, and reduces weak flow. It
doesn’t solve the problem of incomplete emptying of the bladder.
TUNA treatment
TUNA stands for transurethral needle ablation. High-frequency radio
waves, delivered through twin needles, burn a specific region of the
prostate in this procedure. TUNA results in better urine flow and
relieves BPH symptoms with fewer complications than invasive
surgery.
This outpatient procedure can cause a burning sensation. The
sensation can be managed by using an anesthetic to block the nerves
in and around the prostate.
Getting in hot water
Hot water is delivered through a catheter to a treatment balloon
that sits in the center of the prostate in water-induced
thermotherapy. This computer-controlled procedure heats a defined
area of the prostate while neighboring tissues are protected. The
heat destroys the problematic tissue. The tissue is then either
excreted through urine or reabsorbed in the body.
Surgical choices
Invasive surgery for BPH includes transurethral surgery, which
doesn’t require open surgery or an external incision. According to
the National Institutes of Health, transurethral resection of the
prostate is the first choice of surgeries for BPH. The surgeon
removes prostate tissue obstructing the urethra using a resectoscope
inserted through the penis during TURP.
Another method is transurethral incision of the prostate (TUIP).
During TUIP, the surgeon makes incisions in the neck of the bladder
and in the prostate. This serves to widen the urethra and increase
urine flow.
Laser surgery
Laser surgery for BPH involves inserting a scope through the penis
tip into the urethra. A laser passed through the scope removes
prostate tissue by ablation (melting) or enucleation (cutting). The
laser melts excess prostate tissue in photoselective vaporization of
the prostate (PVP).
Holmium laser ablation of the prostate (HoLAP) is similar, but a
different type of laser is used. The surgeon uses two instruments
for Holmium laser enucleation of the prostate (HoLEP): a laser to
cut and remove excess tissue and a morcellator to slice extra tissue
into small segments that are removed.
Open simple prostatectomy
Open surgery may be required in complicated cases of a very
enlarged prostate, bladder damage, or other problems. In open
simple prostatectomy, the surgeon makes an incision below the navel
or several small incisions in the abdomen via laparoscopy. Unlike
prostatectomy for prostate cancer when the entire prostate gland is
removed, in open simple prostatectomy the surgeon removes only the
portion of the prostate blocking urine flow.
Self-care may help
Not all men with BPH need medication or surgery. These steps may
help you manage mild symptoms:
* Do pelvic-strengthening exercises.
* Stay active.
* Decrease alcohol and caffeine intake.
* Space out how much you drink rather than drinking a lot at once.
* Urinate when the urge strikes — don’t wait.
* Avoid decongestants and antihistamines.
Talk with your doctor about the treatment approach that best suits
your needs.