1. The Function of the Prostate
Benign prostatic hyperplasia (BPH) is a non-cancerous type of enlargement of the prostate, which is a small gland that circles the urethra in males and produces fluid that is part of semen. When the prostate enlarges, it puts pressure on the urethra. This causes a slow stream, urgency, hesitancy and dribbling. It may cause urine retention, weakening the bladder muscles which can cause a urinary tract infection.
2. Treatment Plan: Watchful Waiting
When BPH develops and the symptoms are mild and non-life affecting, most physicians will watch and monitor symptoms of the patient. During this time, monitoring should include regular checkups and the prompt reporting of symptoms. It is very important that a urologist (or physician specializing in urology) direct your care if you are in this watching phase.
3. When Is It Time for Medications?
If BPH symptoms cause discomfort, affect those things that are activities of daily living, or endanger the health and well being of a person, drug treatment is recommended. These relieve the symptoms associated with BPH by slowing the growth of the prostate thereby reducing the size. There are two types of medications commonly used to treat BPH; 5-alpha-reductase inhibitors, which relax the urethral-prostatic muscle which improves urinary flow; and alpha-receptor blockers which shrink the size of the prostate.
4. Severe Symptoms Require Intervention
If medications do not give adequate symptom relief, more invasive procedures should be considered, especially if things such as recurrent bladder stones and infections within the urinary tract occur. Non-surgical treatments such as transurethral microwave thermotherapy (TUMT) and transurethral needle ablation (TUNA) are used to decrease the size of the prostate by killing tissue around the prostate to decrease its size. These procedures take about 1 hour and are done on an ambulatory basis.
5. The Surgical Option
Surgical treatments that your doctor might consider are transurethral resection of the prostate (TURP), laser prostatectomy and an open prostatectomy. TURP is the most widely used surgical treatment for BPH. During the TURP procedure, your doctor will use a scope to remove any obstructing tissue to decrease the symptoms of BPH. A laser is used to do the same removal of prostate tissue. In cases where a larger portion of the prostate needs removal, your physician may recommend a prostatectomy, which is the removal of the inner portion of the prostate via an incision in the abdomen. This is a very invasive surgery, usually done for patients with large prostate glands. Surgery usually gives relief from BPH for 15 years or more. It is important to note that there are many new surgical alternatives for BPH and your doctor should discuss the potential benefits and risks of every option.
