Benign Prostatic Hyperplasia: Treatment Options
Benign prostatic hyperplasia is one of the most common complaints in men. As per statistics, from 50 to 85% of men over the age of 50 suffer from this disease and its unpleasant symptoms adversely affect the quality of life and can even cause sexual dysfunction.
It is effective only at the early stages of the disease, whereas at the advanced stages accompanied with complications a surgery may be required. The main objective of the drug therapy is to slow down the growth of prostatic tissue, reduce the size of the prostate and thus relieve lower urinary tract symptoms like nocturia, frequent urination, etc. The following drugs can be used:
- 5-alpha-reductase inhibitors – they block the conversion of testosterone into dihydrotestosterone, a hormone that plays a key role in the progression of the disease. These are drugs like Proscar and Avodart;
- Alpha-blockers – they affect the tone of the urethra, help relax the muscles of the bladder neck and prostate and thus provide easier urine flow. This class of drugs includes Cardura, Hytrin and Flomax.
Surgery is usually indicated for the treatment of the severe symptoms of the disease that have failed to respond to drug therapy. Surgical procedures include:
- Prostatectomy – it is an open surgery performed only in complicated cases with bladder damage, very enlarged prostate, etc. During this procedure, the surgeon makes an incision in the abdomen and removes the part of the prostate that blocks the flow of the urine.
- Transurethral resection of the prostate (aka TURP) – it involves the removal of excess prostate tissue by means of a special tool called resectoscope that is inserted through the urethra. As of today, this type of surgical treatment is considered most beneficial as it reduces the risk of possible complications and decreases the postoperative period.
- Transurethral incision of the prostate (aka TUIP) – this procedure involves the widening of the urethra to make it easier to urinate.
It is a less harsh treatment during which the blood loss is reduced to a minimum.
- Photoselective vaporization of the prostate – a small tube (cystoscope) is inserted into the urethra, a laser is passed through this tube to melt away the excess prostate tissue that blocks the urethra.
- Holmium laser enucleation of the prostate – instead of being melted, the excess prostate tissue blocking the urethra is cut and removed with the help of a special laser.
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