Enlarged Prostate Treatment

Enlarged Prostate Treatment

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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 , Emergency Medicine, answered
    5-alpha reductase inhibitors reduce levels of male hormones (androgens) that cause prostate enlargement. 5-alpha reductase inhibitors include dutasteride (Avodart) and finasteride (Proscar), which have similar effectiveness. The product Jalyn combines dutasteride with the alpha blocker tamsulosin in a single capsule. 

    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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    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.

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    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.

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    There is a wide variety of treatments for an enlarged prostate that can take anywhere from a few days to several months to work. Some medications, like alpha blockers that loosen bladder and prostate muscles, can begin working noticeably within a couple of days. On the other hand, drugs like 5-alpha-reductase inhibitors that reduce the size of the prostate can take several months before an effect is apparent. A surgical procedure like transurethral resection of the prostate (TURP), which uses a tube inserted through the urethra to remove a portion of the prostate, can improve symptoms within a few days. However, similar procedures using needles or microwaves to remove part of the gland can take weeks or months to take effect.

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    After enlarged prostate surgery that requires an incision in the prostate gland, you should relax. Any physical strain could tear the incision so avoid heavy lifting, exercise, driving, and even pushing heavily during a bowel movement. This should be easy initially, since you'll probably spend the first few days in the hospital. Also, take care with what you put in your body. This means taking prescribed medications, drinking plenty of water to flush out your system, and avoiding eating foods that will cause you to strain during bowel movements. Procedures that don't require incisions don't require as much attention post-operation, but they're also less reliable at reducing symptoms of an enlarged prostate.

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    A , Internal Medicine, answered
    There 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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    A side effect of alpha-blocker drugs is that they may affect the smooth muscle within the iris that controls your pupil size. During cataract surgery, your eye surgeon wants your pupil to stay as widely dilated as possible. Alpha-blockers may prevent the pupil from dilating adequately, or may cause the pupil to suddenly constrict. This condition is called intraoperative floppy iris syndrome (iFis), and it can make cataract surgery more complicated

    if it occurs and the surgeon is not anticipating it. This effect on the iris muscle can persist long after stopping the medication.

    Fortunately, these BPH medications do not cause any other problems with your eyesight or vision.

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    For a man with moderate-to-severe benign prostatic hyperplasia (BPH) or enlarged prostate symptoms, alpha-blocker drugs that specifically target prostate muscle contraction are usually the initial treatment. These drugs are less expensive, work faster, and address symptoms better than the enzyme inhibitors finasteride and dutasteride, which reduce the size of the glandular tissue. But for a man who has a palpably enlarged prostate and does not respond to alpha-blockers, enzyme inhibitors are usually prescribed.

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    Transurethral incision of the prostate (TUIP) has been used for 30 years and is simpler, safer, and less expensive than transurethral resection of the prostate (TURP). As with TURP, TUIP is done through the urethra, so there is no incision through the skin. But instead of removing tissue, as with TURP, or destroying the tissue with heat as with the newer technologies, the surgeon widens the urethra and relaxes the constriction of the urethra by making several small incisions in the neck of the bladder down to the prostate capsule. A knife, a laser, or an electrode is used to make the incision, and the instrument of choice is inserted through a resectoscope, as with TURP. TUIP can be performed on an outpatient basis under local anesthesia or as an overnight hospitalization procedure done under spinal or general anesthesia.

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