The prostate is a small, walnut-sized gland that plays a crucial role in the male reproductive system. As men age, it's not uncommon for the prostate to grow, a condition known as benign prostatic hyperplasia (BPH) or enlarged prostate. This can lead to various urinary problems, impacting overall quality of life. Fortunately, there are several treatment options available to address this issue. In recent years, minimally invasive treatments for enlarged prostate have grown in popularity, as they offer effective solutions with fewer side effects and a quicker recovery. Here, we'll dive into the world of minimally invasive procedures for BPH, covering both surgical and non-surgical options.
What is Benign Prostatic Hyperplasia (BPH)?
Benign prostatic hyperplasia (a.k.a. enlarged prostate) is a common condition in aging men that occurs when the prostate tissue continues to grow. The prostate surrounds the urethra, the tube that carries urine from the bladder to the outside of the body. When it enlarges, part of the prostate can press against the urethra, leading to a range of lower urinary tract symptoms, such as:
- Frequent urination, especially at night
- Difficulty starting and stopping urination
- Weak urine stream
- Dribbling at the end of urination
- Incomplete emptying of the bladder
These symptoms can significantly impact a man's quality of life and overall well-being. Luckily, there are various treatment options available to address this issue.
Minimally Invasive Treatment for BPH
Minimally invasive prostate treatments for BPH aim to relieve urinary symptoms and improve the flow of urine by reducing the obstruction caused by the enlarged size of your prostate. These treatments are typically performed on an outpatient basis, require shorter recovery times, and involve less risk compared to traditional surgical methods.
Transurethral Resection of the Prostate (TURP)
TURP is a surgical treatment that has been the gold standard for BPH care for many years. While it is more invasive than other options and requires general anesthesia, it's still considered minimally invasive compared to open surgery. During TURP, a urologist removes excess prostate tissue blocking the urethra. TURP is performed using a resectoscope, a thin tube inserted through the urethra. This procedure allows for the removal of small to moderate-sized prostates effectively. TURP is highly effective in relieving BPH symptoms, and many patients experience significant improvements in urinary flow and quality of life after the procedure. However, it may have some side effects, such as retrograde ejaculation (semen flowing backward into the bladder), which can affect fertility.
Transurethral Incision of the Prostate (TUIP)
TUIP is another minimally invasive surgical procedure used to treat BPH. Instead of removing prostate tissue, the surgeon makes small incisions in the prostate to relieve pressure on the urethra. This procedure is typically performed on men with smaller prostate glands and is associated with a lower risk of sexual side effects than TURP. TUIP is a quick and effective way to address urinary symptoms caused by BPH, and it usually results in minimal downtime for the patient. However, it may not be suitable for men with very large prostates.
Laser Surgery
Laser prostate surgery has become increasingly popular for BPH treatment in recent years. Different lasers, such as Holmium or GreenLight, can be used to vaporize excess prostate tissue. Laser enucleation of the prostate offers a precise and controlled method for reducing prostate size and relieving urinary symptoms. Laser surgery typically results in less bleeding, a shorter hospital stay, and a quicker recovery compared to traditional surgical methods. However, like other treatments, it can still come with potential side effects, such as retrograde ejaculation.
Prostatic Stent Insertion
Prostatic stent insertion is a minimally invasive option involving placing a small, mesh-like urethral stent to keep it open and allow for improved urine flow. This approach is often considered when other treatments are unsuitable or used as a temporary solution until a more definitive treatment can be performed. Prostatic stent insertion is a quick and relatively low-risk procedure done under local anesthesia. It can provide relief from urinary symptoms and improve flow rate, but it may not be a long-term solution for all patients.
UroLift Systems
UroLift is a relatively new and innovative minimally invasive option for BPH. It involves the placement of small implants that hold the enlarged prostate lobes apart, effectively opening the urethra and acting as a prostatic urethral lift. The UroLift procedure can be performed in a urologist's office, and it does not require any cutting, heating, or removal of prostate tissue. UroLift is an excellent procedure to treat BPH for those who want to avoid side effects related to sexual function and have a quick recovery.
Non-Surgical Treatment for Enlarged Prostate
While surgical options have been the go-to treatment for BPH, many men prefer non-surgical alternatives due to the potential for fewer side effects and quicker recovery. Let's explore some non-surgical treatment options below:
Transurethral Microwave Thermotherapy (TUMT)
Transurethral microwave thermotherapy (TUMT) is a non-surgical, minimally invasive procedure for BPH treatment. During TUMT, a special microwave device is inserted into the urethra to deliver heat energy to the prostate tissue. This controlled heat therapy causes the prostate tissue to shrink, relieving urinary symptoms. TUMT is an outpatient procedure that is less invasive than surgical options and associated with minimal side effects. After the procedure, you can return home the same day.
Transurethral Needle Ablation (TUNA)
Transurethral Needle Ablation (TUNA) is another non-surgical option for BPH treatment. During a TUNA procedure, a urologist uses radiofrequency energy delivered through needles. Using electric current to destroy prostate tissue allows precise treatment while preserving the surrounding healthy tissue. TUNA is well-tolerated by patients, with minimal discomfort and a short recovery period.
Prostate Artery Embolization (PAE)
Prostate artery embolization (PAE) is a non-surgical procedure that aims to shrink the prostate by blocking the arteries that supply it with blood. During PAE, a catheter is inserted through a small incision, and small particles are injected into the arteries that feed the prostate. This causes the prostate to shrink over time, relieving urinary symptoms. The PAE procedure is a great procedure to treat men who wish to avoid surgery.
Rezūm Water Vapor Therapy
Rezūm Water Vapor Therapy is a non-surgical, minimally invasive treatment that uses water vapor to treat BPH. During the procedure, sterile water vapor is delivered into the prostate tissue, causing it to shrink. This innovative approach offers effective symptom relief with minimal discomfort and a short recovery.
Lifestyle Changes
While not a medical procedure, making certain lifestyle changes can help manage the symptoms of BPH. These changes may include:
- Reduce fluid intake, especially in the evening, to minimize nighttime urination.
- Avoid caffeine and alcohol, which can irritate the bladder.
- Maintain a healthy weight through diet and exercise.
- Perform Kegel exercises to strengthen pelvic floor muscles.
- Practice timed voiding to ensure regular and complete emptying of the bladder.
Lifestyle changes can be particularly effective when combined with other BPH treatments.
Medications
Medications are another common non-surgical approach to managing BPH symptoms. These medications work in different ways to alleviate urinary symptoms and improve urine flow. There are three primary classes of BPH medications:
- Alpha-reductase Inhibitors — Alpha-reductase inhibitors work by reducing the size of the prostate. These medications slow the growth of the prostate and can help improve urinary symptoms over time. However, they may take several months to show full effectiveness.
- Phosphodiesterase Inhibitors — Phosphodiesterase inhibitors work by relaxing the smooth muscles in the bladder and prostate. These medications can provide relatively quick relief from urinary symptoms and are also used to treat erectile dysfunction.
- Alpha-blockers — Alpha-blockers relax the muscles in the prostate and bladder neck. This results in improved urine flow and symptom relief. Alpha-blockers are often prescribed as a first-line treatment and can provide rapid relief.
In many cases, these medications can effectively manage BPH symptoms and delay the need for surgical intervention. However, they may come with side effects, including dizziness and sexual dysfunction, so it's essential to discuss potential side effects with your healthcare provider.
How to Choose the Right Treatment for Benign Prostatic Hyperplasia
The treatment should be tailored to an individual's specific needs and prostate size. Therefore, consulting with a healthcare provider is essential to determine the most appropriate approach for managing BPH symptoms while considering the patient's overall health and lifestyle. Minimally invasive treatments for an enlarged prostate have revolutionized the field of urology, offering men effective solutions that can lead to a more comfortable and symptom-free life. For more information on improving your urologic health, or for support of common urologic conditions like enlarged prostate, contact Byram Healthcare today.
