As men get older, the cells of the prostate begin to swell, which increases the size of the prostate. This is non-cancerous and is called benign prostatic hyperplasia (BPH). The enlarged puts pressure on the urethra (the tube through which you pass urine). This can make it difficult to pass urine and may cause urinary symptoms such as hesitancy, straining, weak stream, dribbling, incomplete emptying, frequency, urgency and nighttime urination. The enlargement can also lead to complications like retention (inability to urinate), urinary tract infections, hematuria (blood in urine), epididymorchitis (infection of testicle) and in rare cases, bladder damage and kidney failure.
Treatments for enlarged prostate
The first line treatment is medical therapy or minimally invasive therapy (UROLIFT or REZUM). Medical therapy includes use of alpha blocker, 5-alpha reductase inhibitor, phosphodiestrace inhibitor and anticholinergic medications. In some patients, combination therapy may be utilized. Medical therapy is half as effective as minimaly invasive therapy and 25% as effective as surgical therapy.
Patients not responding to medical therapy or patients having complications from BPH usually require minimally invasive (UROLIFT or REZUM) or surgical therapy ( HOLEP, TURP, PVP, Aquablation, simple prostatectomy). The type of therapy depends on the prostate size, prostate anatomy and patient factors (comorbidties and use of blood thinners). The urologist may perform additional studies like cystoscopy, transrectal prostate ultrasound and urodynamic study to decide the best procedure for the patient.
Below are a list of some of the treatment options for an enlarged prostate.
- UroLift ® System
- Transurethral resection of prostate (TURP)
- Holmium laser enucleation of prostate (HOLEP)
- Green light vaporization of prostate (PVP)
- Simple prostatectomy (open or robotic)
- Prostate artery emolization
- Rezūm
- Aquablation
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UroLift ® System
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Transurethral resection of prostate (TURP)