Benign prostatic
hyperplasia treatment options

BPH Treatments

There are effective treatments available at SanoMed for prostate gland enlargement, including medications, minimally invasive therapies and surgery.

To choose the best option, you and your doctor will consider your symptoms, the size of your prostate, other health conditions you might have, and your preferences.

The primary categories of treatment options are:

In some cases no active treatment may be the recommended option. If a man has minimal bothersome symptoms from his enlarged prostate the doctor may recommend “watchful waiting”, perhaps combined with lifestyle factors like diet and exercise.

Please see below for more information on each of the primary treatment categories. You will also find enriched detail on each individual treatment on the site pages for each category. This information is not intended to be an exhaustive list of all possible treatments for an enlarged prostate, but presents common therapy options for your information.

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Medication for BPH

Medicine is one of the most common ways to treat men with mild to moderate BPH symptoms.

The primary types of medications prescribed for men with lower urinary tract symptoms due to benign prostate hyperplasia are Alpha Blockers and 5-Alpha Reductase Inhibitors.

  • These pills relax the muscles of the prostate and bladder to improve urine flow. They reduce symptoms of BPH and blockage of the urethra. The pills do not reduce the size of the prostate. Alpha blockers work almost immediately and provide much relief for urinary problems.
  • If you have high blood pressure and BPH, alpha blockers may be a good option for you because they treat both conditions.
  • Side effects: Since alpha blockers affect your blood pressure, they can make you feel very tired and cause dizziness, headaches, and low blood pressure.
  • These pills block the body’s production of dihydrotestosterone (DHT) which has been considered to be a factor in prostate enlargement. These pills are particularly effective for men with prostates that have grown so large they are imposing on the bladder or urethra.
  • These drugs may lower the risk that BPH will lead to other problems like bladder damage, and reduce the chances that you will eventually need a surgical procedure to reduce the prostate. It can take up to 6 months to see the full effects of 5-ARIs, and you have to keep taking them to get results.
  • Side effects: Men taking these meds may experience erectile dysfunction, a lower sex drive, or retrograde ejaculation. Some of these side effects may get better as your body gets used to the medicine.

Tissue Removal Surgery

If the patient has attempted other treatments without success, is unable to urinate or has bladder stones, surgery may be required. Common surgical options include these procedures.
  • The doctor goes through the urethra with a scope and removes portions of the prostate that are affecting your urinary flow. This is the most common surgical procedure for enlarged prostate.
  • TURP is performed under general or spinal anesthesia, After surgery, the newly enlarged passageway enables urine to flow more easily,
  • This procedure removes the inner part of the prostate through an abdominal incision. It is applied when the size of the prostate is too large for a TURP.
  • It is done under a general or spinal anesthetic. The procedure requires a slightly longer hospital stay and recovery period than transurethral resection of the prostate (TURP).
  • The surgeon uses a high-energy laser to vaporize some of the tissue blocking the prostate. This opens the prostate to let urine flow more easily.
  • The GreenLight laser procedure is typically performed on an outpatient basis under general anesthesia. Most patients experience rapid relief of BPH symptoms and improvement in urine flow after the procedure.
  • The holmium laser is a surgical laser that has been found particularly effective in performing several types of urological surgeries. In the case of HoLEP, the laser is used to cut and remove the bulky prostate tissue that is blocking the flow of urine.
  • Patients who are appropriate for HoLEP are typically symptomatic due to very large prostates. It is done under a general or spinal anesthetic.

Minimally Invasive Surgical Therapies (MIST) for BPH

MIST procedures can be done right in the doctor’s office to eliminate excess prostate tissue without general anaesthesia. Minimally invasive therapies are increasingly available and recommended when possible as an alternative to the risks of surgery.

  • Rezūm is an in-office treatment designed to reduce BPH symptoms in certain men with enlarged prostates — without the side effects of BPH medications.
  • Controlled doses of hot steam are applied directly into the enlarged prostate tissue via a handheld device. Water vapour is injected into the prostate tissue that blocks urinary flow gently and immediately causing cell damage.
  • Over time, the body will absorb the treated tissue with its natural healing response. The volume of the prostate can then be reduced to 40%, in 3 to 6 months.
  • Urolift is a minimally invasive approach to treating an enlarged prostate that holds the prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
  • Clinical data has shown that the UroLift is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function.
  • This procedure can be performed on an outpatient basis.
  • The TUMT procedure uses the heat from a microwave antenna into the bladder to destroy excess prostate tissue. The doctor guides a thin catheter carrying a miniature microwave generator through the penis to the prostate. Microwaves destroy some of the prostate tissue and relieve pressure on the urethra.
  • The procedure can be performed on an outpatient basis.

Lifestyle Factors

To help control the symptoms of an enlarged prostate, you can:

  • Limit beverages in the evening. Don’t drink anything for an hour or two before bedtime to avoid middle-of-the-night trips to the toilet.
  • Limit caffeine and alcohol. They can increase urine production, irritate the bladder and worsen symptoms.
  • Limit decongestants or antihistamines. These drugs tighten the band of muscles around the urethra that control urine flow, making it harder to urinate.
  • Go when you first feel the urge. Waiting too long might overstretch the bladder muscle and cause damage.
  • Schedule bathroom visits. Try to urinate at regular times — such as every four to six hours during the day — to “retrain” the bladder. This can be especially useful if you have severe frequency and urgency.
  • Follow a healthy diet. Obesity is associated with enlarged prostate.
  • Stay active. Inactivity contributes to urine retention. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.
  • Urinate — and then urinate again a few moments later. This practice is known as double voiding.
  • Keep warm. Colder temperatures can cause urine retention and increase the urgency to urinate.
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