Time to Do Something about Your Enlarged Prostate?
As men age, they tend to have an enlarged prostate. This is can be challenging as you may have to get up several times at night or even develop urinary problems. BPH is often challenging because it could completely affect the quality of life you enjoy and even worst, lead to severe conditions like kidney stones and bladder damage. The question is, what are the available conventional options for treating an enlarged prostate?
Alpha-blockers help relax the prostate and bladder muscles. Good examples are terazosin (Hytrin) or tamsulosin (Flomax). You can also take dutasteride (Avodart) or finasteride (Proscar), which is a different kind of medication for reducing BPH symptoms. These two work by blocking the hormones that cause the prostate to grow.
Minimal invasive surgery
For men who have trouble urinating minimal invasive surgery is the best surgical option. Men with moderate to severe BPH symptoms who have trouble urinating, bladder stones, blood in the urine or urinary tract obstruction are good candidates. Invasive surgery doesn’t require open surgery or an external incision. The surgeon removes prostate tissue obstructing the urethra using a resectoscope inserted through the penis during TURP
Transurethral resection of the prostate (TURP)
Transurethral resection of the prostate is typically the first choice of surgeries for BPH. During transurethral resection of the prostate (TURP), the surgeon will put a resectoscope through the end of the penis and through the urethra to remove tissue of the prostate gland.
The TURP procedure does not require an incision. As an alternative, the resectoscope has a lighted camera and electrical loop, as well as valves that maintain irrigating fluid. The tissue is cut, and the blood vessels sealed with the loop. At the end of the TURP, the tissue pieces are removed through the irrigating fluid into the bladder and then flushed from the body.
Transurethral Incision of the Prostate (TUIP)
This procedure involves passing a narrow instrument through the urethra to the junction of the prostate and bladder. The instrument delivers an electrical current or laser beam that cuts muscles in the bladder neck, which then allows urine to flow more freely.
Laser surgery for BPH is done by inserting a scope through the penis tip into the urethra. The laser melts the prostate tissue through a process called ablation (melting) or enucleation (cutting). The laser melts excess prostate tissue in photoselective vaporization of the prostate (PVP).
Another type of laser used is the Holmium laser ablation of the prostate (HoLAP). Here, the surgeon employs 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 then removed.
Open simple prostatectomy
In complicated cases of a very enlarged prostate, bladder damage, kidney problems or other problems, open surgery may be required. 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.
Rezum therapy involves injecting a water stream into the prostate under local anaesthetic.
The Urolift procedure
This procedure involves placing small implants to hold the prostate tissue apart from around the urethra. Specifically, tiny implants are placed in the lobes of the prostate to open the urethra.
Transurethral microwave therapy (TUMT)
This procedure uses a microwave antenna attached to a flexible tube that your doctor inserts into your bladder. The microwave heat kills off excess prostate tissue.
Transurethral needle ablation (TUNA)
This procedure involves inserting a heated needle into the prostate through the urethra. The heated needle uses radiofrequency waves to heat up and destroy excess cells in the prostate gland.
The general principle of these treatments: transurethral microwave thermotherapy (TUMT), transurethral radiofrequency needle ablation of the prostate (TUNA), and interstitial laser coagulation (ILC) is that, in each case, the prostate tissue is heated to a level that will lead to death of portions of the prostate tissue, thus shrinking away and removing some of the obstruction. However, TUMT and TUNA have some urinary side effects that can last only for several weeks.
The Rezum and Urolift procedures have the advantage of preserving ejaculatory function, which can be affected by almost all other prostate procedures.
Before you think over the options for surgery, ask your doctor these questions:
- Is there a good chance my condition will get better?
- How much will it improve?
- What are the chances of side effects from a treatment?
- How long will the effects last?
- Will I need to have this treatment repeated?
- What are the usual risk factors associated with my surgery?
Even though the outcomes of most of these procedures are generally successful, there are natural, healthier options that could treat an enlarged prostate without side effects. We recommend surgery as a last option. It completely depends on your case and what you and your doctor decide is best for you.