Enlarged Prostate Treatment
1 AnswerTo perform a laser procedure for benign prostatic hyperplasia (BPH), the surgeon begins by guiding a fiber through the urethra to the prostate. This fiber conducts the laser light to the target area. Then the surgeon uses the laser to burn away tissue that obstructs the urine flow. Dead tissue that's not immediately vaporized is later expelled in the urine. This technique destroys prostate tissue with less bleeding than standard transurethral resection of the prostate (TURP), an incision-free surgical procedure that cuts away excess prostate tissue with an electrical loop.
1 AnswerThese 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.
1 AnswerRealAge answeredGenerally, 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.
1 AnswerRealAge answeredHere are the pros of using saw palmetto to help treat benign prostatic hyperplasia (BPH):
- Has been used for many years in Europe
- Similar effectiveness as finasteride
- Three out of four get some favorable response; symptom score reduced by an average 28%; peak flow rate increased by an average 24%
- Minimal side effects; no drug interactions
- No restrictions on the duration of use
- Only herb with reasonable scientific evidence of effectiveness
2 AnswersIn 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%.
1 AnswerLaser 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.
1 AnswerDuring photoselective vaporization of the prostate (PVP), also called the GreenLight procedure, the surgeon threads a thin tube called a cystoscope through the urethra into the enlarged prostate. The surgeon then threads a fiber-optic device through the cystoscope to generate high-intensity pulses of light, which simultaneously vaporize the obstructing tissue and cauterize it to reduce bleeding. This creates an enlarged, uniform channel through which urine can flow.
Certain herbal medications have shown some effectiveness in treating an enlarged prostate. The most popular is the palm plant saw palmetto, which some studies have shown to improve symptoms of enlarged prostate. However, other studies have concluded that it has no benefit, so further clarification is needed. Other herbal remedies that some people use to treat enlarged prostate include rye grass, stinging nettle, and an African bark called pygeum. Be sure to consult with your doctor before taking herbal remedies, since it's possible that they could have negative side effects or even react with other medications you're taking.
6 AnswersDr. Michael Roizen, MD , Internal Medicine, answeredThere are a number of transurethral procedures your doctor might consider like laser prostatectomy, microwave prostatectomy, and electrovaporization. These procedures can remove some of the inside tissues of the prostate using various technologies to relieve inflammation and reduce symptoms associated with BPH.
In general, these are outpatient, simple procedures, and your urologist can help you choose the one that will best alleviate your symptoms. Downside: these procedures may need to be repeated, and in case you haven't translated transurethral yet, then realize that an instrument's gotta go into a hole that's used to letting urine out.
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1 AnswerStudies have established a physiological link between erectile dysfunction and the urinary symptoms that accompany benign prostatic hyperplasia (BPH). Prescribed for erectile dysfunction, phosphodiesterase-5 (PDE5) inhibitors augment cyclic guanosine monophosphate (GMP), a chemical that relaxes smooth muscle in the penis, improving blood flow during sexual stimulation. PDE5 inhibitors -- sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) -- also seem to relax smooth muscle in the bladder neck, urethra, and prostate. A handful of clinical trials have shown that these drugs improve both erectile function and urinary symptoms in men with both conditions.
The FDA recently approved tadalafil for both BPH and the erectile dysfunction that frequently accompanies it.