Enlarged Prostate Treatment

Enlarged Prostate Treatment

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  • 2 Answers
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    A , Hematology & Oncology, answered
    In the treatment of benign prostatic hyperplasia (BPH), transurethral incision of the prostate (TUIP) involves inserting an instrument into the prostate via the penis. But rather than cutting away excess tissue, the surgeon makes one or more deep lengthwise incisions in the prostate at the site of the urethral constriction. This opens the urethral passage, relieving pressure on the urethra and improving urine flow. Spinal or general anesthesia is generally used for TUIP, which can be performed on an outpatient basis or during a one-day hospital stay. Recovery usually takes five to seven days.

    TUIP is not an option for every patient. Men with small prostates are the usual candidates for this procedure. The benefits appear to last. Over a five-year period, the chance of needing further surgery is 8% to 10%.
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  • 1 Answer
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    A , Hematology & Oncology, answered
    Laser surgery is widely available for treating benign prostatic hyperplasia (BPH). Although usually performed in a hospital setting, laser surgery is less traumatic than transurethral resection of the prostate (TURP), an incision-free surgical procedure that cuts away excess prostate tissue with an electrical loop, and most patients go home the same day.

    Surgeons originally used low-energy lasers for these procedures. Now high-energy lasers are becoming more popular. The advantage of these over TURP or low-energy laser sources to remove prostate tissue is that bleeding is reduced and the catheter may be removed much earlier, often within 24 hours. Overnight hospitalization often is not needed. One type of high-energy laser, called a potassium-titanyl-phosphate (KTP) laser, is used during a procedure called photoselective vaporization of the prostate (PVP). During PVP, the surgeon can view the prostate and remove large amounts of tissue with little bleeding. Indeed, even patients on blood-thinning medication may undergo PVP while still taking their medications.
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    A , Hematology & Oncology, answered
    These simple steps can help relieve some of the symptoms of benign prostatic hyperplasia (BPH):
    • Reduce stress by exercising regularly and practicing relaxation techniques such as meditation. Some men who are nervous and tense urinate more frequently.
    • When you go to the bathroom, take the time to empty your bladder completely. This will reduce the need for subsequent trips to the toilet and reduce the amount of urine that stagnates in the bladder, which can lead to infections and stone formation.
    • Talk with your doctor about all prescription and over-the-counter medications you take; some, such as antihistamines and decongestants, may contribute to the problem. Your doctor may be able to adjust dosages or change your schedule for taking these drugs, or he or she may prescribe different medications that cause fewer urinary problems.
    • Avoid drinking fluids in the evening, particularly caffeinated and alcoholic beverages. Both can affect the muscle tone of the bladder, and both stimulate the kidneys to produce urine, leading to nighttime urination.
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    A , Emergency Medicine, answered
    Side effects may include headaches, drowsiness, weakness, fainting, nasal congestion, and nausea. Other side effects may include frequent urination or loss of bladder control, and a rapid, strong, or irregular heartbeat. Alpha blockers can make it dangerous to drive or to operate machinery.

    This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.
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    A , Emergency Medicine, answered
    If you are taking a CY3PA4 inhibitor, dutasteride may not be a good option for you.
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    A answered
    Generally, there are three situations that favor treatment of benign prostatic hyperplasia (BPH), also known as enlarged prostate:
    • When urinary problems are bothersome enough to affect quality of life
    • When the severity, or frequency, of urinary symptoms increases, posing a threat to the urinary system
    • When a complication already exists, such as recurrent urinary tract infections, recurrent blood in the urine, acute urinary retention that persists after catheterization, bladder stones, overflow incontinence, or signs of kidney malfunction

    There is no urgency to treat BPH, unless there is some kind of severe obstructive complication that can threaten the bladder or kidneys. The appropriate treatment (or nontreatment) strategy is an individual decision, made in consultation with your primary healthcare practitioner or urologist, after considering all the benefits and risks of each option.

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    A answered

    In laboratory studies, Pygeum africanum has been shown to inhibit prostate cell proliferation by reducing the response to a variety of growth factors. Pygeum africanum also is thought to produce anti-inflammatory effects and has been shown to improve bladder function in animal studies.

    In Europe, a Pygeum africanum product called Tandenan is most commonly used. The usual dose is 100 mg per day.

    There is limited research on the effectiveness of Pygeum africanum in men with symptomatic benign prostatic hyperplasia (BPH). As with most herbal therapies, most available studies on this bark are short term, and the supplements used are not standardized. In fact, when a review of the best quality studies using Tandenan (the European prescription product derived from Pygeum africanum) was attempted, no conclusions could be drawn because of inconsistency in the studies and results.

    A few placebo-controlled studies from Europe, however, have demonstrated some positive effects.

    In a six-week study involving 120 men, those who took Pygeum africanum had a greater improvement in several urinary symptoms than men who took a placebo.

    Another study of 263 men over two months found that 66% of men taking Pygeum africanum felt that they improved, whereas 31% of men taking a placebo felt this way.

    Still, Pygeum africanum remains unproven as a treatment for BPH.

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    A answered

    In the treatment of benign prostatic hyperplasia (BPH), or enlarged prostate, high-intensity focused ultrasound (HIFU) uses ultrasound energy to heat and to destroy the obstructing prostate tissue instead of coagulating it as with transurethral microwave thermotherapy (TUMT) or transurethral needle ablation (TUNA). A transrectal probe gives off waves that focus on a precise area of the prostate. HIFU uses very high temperatures.

    As an invasive procedure, HIFU should be effective and produce durable results. Early results of studies that focus on this technique are promising but not convincing. No placebo-controlled or randomized comparison studies have been reported. Such studies are needed before HIFU can be recommended as a viable alternative.

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    A , Hematology & Oncology, answered
    A randomized, prospective clinical trial published in The Journal of Urology compared the safety and effectiveness of transurethral needle ablation (TUNA), a procedure that uses radio waves to heat and destroy prostate cells obstructing the urethra, with transurethral resection of the prostate (TURP) -- the most common procedure for benign prostatic hyperplasia (BPH), in which excess prostate tissue is cut away.

    Researchers at seven centers in the United States enrolled 121 men in the trial; 65 underwent TUNA, and 56 had TURP. Over five years, both groups of men reported significant improvement in symptoms, quality of life, urine flow, and post-void residual volume (the amount of urine left in the bladder after attempting to void). But in most cases, the improvements were greater among the TURP patients. Patients who had TURP were less likely to need a second procedure than TUNA patients -- 1.8% versus 13.8%.

    However, patients undergoing TURP experienced more adverse events, or side effects, of the procedure than patients undergoing TUNA. For example, the incidence of erectile dysfunction following TUNA was 3.1%, versus 21.4% for TURP. None of the patients in the TUNA group experienced retrograde ejaculation, but 41% of the patients who underwent TURP did.
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    A answered

    Transurethral vaporization of the prostate (TUVP or TVP) is the most recently introduced technology to treat benign prostatic hyperplasia (BPH). TUVP was developed to overcome some of the major problems associated with the surgical procedure known as transurethral resection of the prostate (TURP), such as bleeding, catheterization time, and long hospital stays and recovery time.

    The new technique is a modification of TURP: With TURP, a very thin, wire loop with an electric current is used to cut away pieces of the obstructing tissue in the prostate. In TUVP, a special, grooved, roller electrode (usually shaped like a cylinder) is inserted through a resectoscope, delivering a strong electric current. The roller electrode is rolled over the tissue, vaporizing -- instead of cutting away at -- the top 1 to 3 millimeters of tissue. (In this way, TUVP is comparable to laser vaporization techniques.)

    Unfortunately, with each pass of the roller, the layer below the vaporized tissue becomes more solid, or coagulated. This coagulated tissue is harder to vaporize -- a drawback that makes the procedure more tedious and time-consuming. For this reason, TUVP is best limited to men with small prostates.