[vc_row][vc_column][vc_column_text]Benign prostatic hyperplasia (BPH) is a condition that affects almost every man, particularly the older ones. The condition is characterized by an enlarged prostate, which is a gland present near the rectum and bladder, surrounding the urethra, and it is an important part of the male reproductive system. Due to the location of the gland, its enlargement may press against and pinch the urethra, making the bladder wall thicker and causing urinary problems. Depending on the patient and severity of the benign prostatic hyperplasia, treatment range from lifestyle changes and watchful waiting, to medication, minimally invasive procedures or surgery.
Lifestyle Changes and Watchful Waiting in Patients with Benign Prostatic Hyperplasia
For men whose symptoms of benign prostatic hyperplasia are mild, a physician may recommend lifestyle alterations and keeping track of the prostate health with regular examination. Regarding changes in habits, the National Institutes of Health (NIH) recommend “reducing intake of liquids, particularly before going out in public or before periods of sleep, [and] avoiding or reducing intake of caffeinated beverages and alcohol.”
In addition, the NIH also notes that avoiding or monitoring the use of medications such as decongestants, antihistamines, antidepressants, and diuretics, as well as training the bladder to hold more urine for longer periods, exercising pelvic floor muscles and preventing or treating constipation may also be helpful. Patients with a sedentary lifestyle have more probability of suffering from numerous diseases, which is why having a healthy diet and partaking in exercise may also improve overall health.
Medication for the Treatment of Benign Prostatic Hyperplasia
The use of medication to treat benign prostatic hyperplasia is usually recommended to stop the growth of the prostate, shrink it, or reduce the symptoms. The most common type of medications prescribed are alpha blockers, which are drugs meant to relax the smooth muscles of the prostate and bladder neck to improve urine flow and reduce bladder blockage. These include terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral), and silodosin (Rapaflo). Phosphodiesterase-5 inhibitors are also used to treat erectile dysfunction, while Tadalafil (Cialis) in particular is able to address the symptoms of lower urinary tract, by relaxing smooth muscles.
The third group of drugs that may be prescribed to patients with benign prostatic hyperplasia are 5-alpha reductase inhibitors, such as finasteride (Proscar) and dutasteride (Avodart), which block the production of dihydrotestosterone (DHT), a hormone that accumulates in the prostate and may cause prostate growth. In addition, physicians may recommend a combination of medication, since using two classes of medications may be more effective than just one in the improvement of the symptoms and urinary flow. The combinations include finasteride and doxazosin, dutasteride and tamsulosin (Jalyn), or alpha blockers and antimuscarinics.
Benign Prostatic Hyperplasia Treatment with Minimally Invasive Procedures
When medication is ineffective in helping a patient improve the symptoms of benign prostatic hyperplasia, physicians may perform minimally invasive procedures, which are designed to destroy enlarged prostate tissue or widen the urethra, helping relieve blockage and urinary retention. Transurethral needle ablation is one of these treatments and it uses heat generated by radiofrequency energy to destroy prostate tissue, while a transurethral microwave thermotherapy uses microwaves to destroy prostate tissue, and a high-intensity focused ultrasound uses ultrasound waves from probe heat.
Other minimally invasive procedure is transurethral electrovaporization, during which a resectoscope is inserted through the urethra and an electrode attached transmits an electric current that vaporizes prostate tissue. During a water-induced thermotherapy, heated water is inserted through a catheter into the urethra so that a treatment balloon rests in the middle of the prostate, targeting a specific region of the gland. The last type of treatment is a prostatic stent insertion, which consists of the insertion of a prostatic stent through the urethra to the area narrowed by the enlarged prostate in order to push back the prostate tissue, widening the urethra.
Surgical Procedures to Treat Benign Prostatic Hyperplasia
Surgery for the treatment of benign prostatic hyperplasia is an option when medications and minimally invasive procedures are ineffective, symptoms are particularly bothersome or severe, and complications arise. Surgery to remove enlarged prostate tissue includes transurethral resection of the prostate (TURP), laser surgery, open prostatectomy, and transurethral incision of the prostate (TUIP), but the NIH emphasizes that “although removing troublesome prostate tissue relieves many benign prostatic hyperplasia symptoms, tissue removal does not cure benign prostatic hyperplasia.”
TURP is the most common type of surgery, during which a resectoscope is inserted through the urethra to reach the prostate and cuts pieces of enlarged prostate tissue with a wire loop. Laser surgery, on the other hand, resources to a high-energy laser through the urethra into the gland in order to destroy prostate tissue. In an open prostatectomy, a urologist opens an incision to reach the prostate and remove all or part of the prostate. In addition, the TUIP is a surgical procedure to widen the urethra, which is done inserting a cystoscope and an instrument that uses an electric current or a laser beam through the urethra to reach the prostate.
Note: BPH News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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