How is benign prostatic hyperplasia treated?
Patients with mild symptoms may not require treatment other than continued observation to make sure their condition doesn't get worse. This approach is sometimes called "watchful waiting" or surveillance. There are a number of treatment options available if your symptoms are severe:
Treatments for BPH include:
Proscar was one of the first drugs used to treat BPH. It works by slowing the production of the hormone dihydrotestosterone (DHT), which affects the growth of the prostate gland. Proscar appears to be most beneficial for men with larger prostates.
Drugs that relax the muscle in the prostate (to reduce the tension on the urine tube) are more commonly used. These include Hytrin®, Cardura®, and Flomax®. The most common side effects are light-headedness and weakness.
A number of surgical procedures have been used to remove the prostate tissue blocking the flow of urine.
- Transurethral resection of the prostate (TURP): This is the most common procedure. There are several different variations on this technique. It involves removing the tissue blocking the urethra (urine tube) with a special instrument. Although TURP is an effective treatment, there are potential side effects, including bleeding, infection, impotence (inability to maintain an erection suitable for sex) and incontinence (inability to control the flow of urine).
- Transurethral electrovaporization: This technique uses electrical energy applied through an electrode to rapidly heat prostate tissue, turning the tissue cells into steam. This allows the doctor to vaporize an area of the enlarged tissue and relieve urinary blockage.
- The Greenlight laser: This is commonly used to treat BPH and is associated with less bleeding after the procedure.
Another, less complicated procedure is transurethral incision of the prostate (TUIP). Instead of removing tissue, as with TURP, this approach involves widening the urethra by making several small cuts in the bladder neck (area where the urethra and bladder join), as well as in the prostate gland itself. This relieves some of the pressure on the urethra and improves urine flow.
Minimally invasive treatments
New treatments have been developed in recent years that can effectively reduce the size of the prostate and relieve urinary blockage, but are less invasive and damaging to healthy tissue than is surgery. In general, minimally invasive procedures require less time in the hospital, result in fewer side effects, are less costly, and allow for quicker recovery. The most common side effects reported with these treatments include urinary frequency and irritation while the prostate is healing. However, many of these techniques are new, and little is known about the long-term effectiveness and complications of these procedures.