Treatment Treatment for Benign Prostatic Hyperplasia (BPH)

Medications

Medication is the first line of treatment and usually these are used in combination.

There are two classes of medications to treat this prostate condition:

Alpha-blockers

  • “Urine channel openers” – relax the smooth muscle of the prostate gland and thus improve urinary symptoms.

5-alpha-reductase inhibitors

  • “Prostate shrinkers” – block the production of dihydrotestosterone (DHT), which is felt to play a pivotal role in the prostate growth.

Transurethral Resection of the Prostate (TURP)

Transurethral Resection of the Prostate (TURP)  is the prostate surgery procedure most commonly used to treat BPH and is technically a minimally invasive procedure. The surgeon uses a camera and a this hot wire to resect the prostate tissue that is blocking the urethra. This is done through the urethral channel in the penis. By removing the tissue blocking the channel the urine can exit from the bladder.

Risks and complications include:

  • Bleeding
  • Fluid absorption
  • Hyponatremia (low sodium)
  • Incontinence
  • Very rarely erectile dysfunction

Photoselective Vaporization of the Prostate (PVP)

This procedure uses a GreenLight Laser™ that emits a laser energy wavelength that is absorbed by oxyhemoglobin.

Essentially the prostate tissue is vaporized in the process in a nearly bloodless fashion.

Risks include:

  • Need for blood transfusion
  • Fluid absorption
  • Hyponatremia
  • Incontinence
  • Very rarely impotence

These risks are reduced in PVP compared to traditional TURP.

Minimally Invasive Therapies (MIT)

There are a variety of other minimally invasive treatments:

  • UroLift® | FDA Cleared BPH Treatment for Enlarged Prostate
  • Transurethral needle ablation (TUNA)
  • Transurethral microwave therapy (TUMT)
  • Interstitial laser coagulation of the prostate (ILC)

Simple Prostatectomy

Simple Prostatectomy is done for patients with urinary retention who have very large prostates over 80 grams. All surgeries require hospitalization and a drainage tube called Foley catheter that will remain from 2-7 days.

This can be done a variety of ways:

  • Open Retropubic Simple Prostatectomy – through an incision, the surgeon will move the bladder aside, cut into your prostate, and remove the blocking core of the gland. The capsule or shell of your prostate is then closed.
  • Open Suprapubic Simple Prostatectomy – your surgeon will make an incision in the lower abdomen, then open the  bladder to remove prostate tissue through the bladder.
  • Robotic Simple Prostatectomy – here the surgeon makes 5 small incisions in the abdomen. Cameras and surgical instruments are put into the holes to help your surgeon remove the enlarged prostate core that is blocking the urethra. The core is removed through one of the small holes in the abdomen.

Follow Up

  • Medications
  • Surgery
  • Heat therapy to prostate
  • Embolization of blood vessels to the prostate