If the symptoms of BPH are affecting the quality of your life, it is time to seek treatment for your prostate. For example, if you are losing sleep because you need to constantly urinate during the night, then you should consult a urologist about what is likely an enlarged prostate.
BPH may be managed through selective medications. Urologists generally use two classes of medications to treat this prostate condition: alpha-blockers and the 5-alpha-reductase inhibitors. Alpha-blockers are used to relax the smooth muscle of the prostate gland and thus improve urinary symptoms. The 5-alpha reductase inhibitors block the production of dihydrotestosterone (DHT), which is felt to play a pivotal role in the prostate's growth. Urologists at the prostate center currently participate in clinical studies of the latest available types of these medications.
Transurethral Resection of the Prostate (TURP)
Transurethral Resection of the Prostate is the prostate surgery procedure commonly used to treat BPH. This has been considered the “gold standard” of surgical care for the last few decades. In this cystoscopic procedure the urologist uses a wire loop, which has been charged with an electrical current to remove the prostate tissue. This effectively removes the obstructive in the prostate tissue blocking the urine from exiting the bladder. TURP is performed under regional or general anesthesia. The average in hospital stay for this prostate surgery is 1 to 2 days and potential complications may include bleeding, fluid absorption, hyponatremia, incontinence, and potentially erectile dysfunction.
Photoselective Vaporization of the Prostate (PVP)
F.D.A. approved in March of 2002, 200 of these procedures have been performed in the Glickman Urological and Kidney Institute. The procedure uses the GreenLight Laser™ produced by Laserscope. It uses a fiber that emits a laser energy wavelength that is absorbed by oxyhemoglobin. Because of this physical principle, the vaporization of the prostatic tissue can be accomplished in a nearly bloodless fashion. The risks of blood transfusion, fluid absorption, hyponatremia, incontinence, and impotence have all been assessed in a recent clinical trial done at our Institute and the results appear quite favorable. PVP is a type of prostate surgery performed on an outpatient basis at both Cleveland Clinic main campus as well as our Strongsville location.
Minimally Invasive Therapies (MIT)
There continue to be a variety of other minimally invasive treatments offered through out our Institute including transurethral needle ablation (TUNA), transurethral microwave therapy (TUMT), and interstitial laser coagulation of the prostate (ILC). These outpatient office based procedures employ the concept of heating the prostatic tissue to a point where the prostatic cells are unable to survive secondary to the heat treatment. The body subsequently reabsorbs this prostate tissue over a two to three month period following prostate surgery. Catheterization between 5 to 7 days is required.