Background:

Also called benign prostatic hyperplasia (BPH) and prostatic hypertrophy, prostate gland enlargement can cause bothersome urinary symptoms. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems.  BPH affects more than 50% of men over the age of 50 and more than 80% older than 80 years old.

There are several effective treatments for prostate gland enlargement. In deciding the best option for you, you and your doctor will consider your particular symptoms, the size of your prostate, other health problems you may have and your preferences. Your choices may also depend on what treatments are available in your area. Treatments for prostate gland enlargement include medications, lifestyle changes and surgery, and minimally invasive options.  Complication rates from treatments vary with each procedure and may include the following, but this list is not all inclusive: impotence (erectile dysfunction), incontinence (urine leakage), stricture (blockage of urine), bleeding, retrograde ejaculation (reversal of ejaculate direction) and injury to nearby organs (bladder or rectum). These can be discussed with your doctor.

Treatment Options:

TURP - Transurethral resection of the prostate (TURP) is a type of prostate surgery.  During a TURP procedure, a surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the resectoscope, your doctor trims away excess prostate tissue that's blocking urine flow and increases the size of the channel that allows you to empty your bladder. TURP is one of the most effective options for treating urinary symptoms caused by BPH. To determine whether TURP or another treatment is the right choice for you, your doctor will consider how severe your symptoms are, what other health problems you have, and the size and shape of your prostate.

Laser Surgery - Also known as Photoselective vaporization of the prostate (PVP), this is a minimally invasive method of treating BPH.  One commercially known device is the greenlight laser. During laser PVP surgery, a catheter with a camera system (cystoscope) is inserted into the penis. A urologist places a laser through the cystoscope to burn away (vaporize) excess prostate tissue. This may ease the blockage of the urethra and enlarges the opening to allow better urine flow during urination. This can be effective therapy, but may not be as durable and long lasting as TURP.

Prostate Artery Embolization - In this outpatient procedure, interventional radiologists insert a spaghetti sized catheter into a leg artery (femoral artery) in the groin area and guide this catheter to the prostate arteries.  A material may be injected in the artery, if deemed appropriate, to block the blood vessels going to the hypervascular nodules that form in Benign Prostatic Hyperplasia (BPH). These nodular growths are also called prostatic adenomas.  By blocking the blood vessels to the nodular growths, the prostate may shrink and thereby reduce the blockage of urine and pressure on the bladder. Catheters or probes are not routinely placed through the penis for this procedure.  To determine whether you are candidate for this procedure as part of routine medical practice, your doctor will discuss how severe your symptoms are, what other health problems you have, and the size and shape of your prostate. The embolic material that is injected in to the arteries (embolic material) is not FDA approved for the specific indication of treatment of an enlarged prostate/BPH and its use is considered off label by the FDA.

Microwave Therapy - Transurethral microwave therapy (TUMT) is usually an outpatient procedure where a small microwave antenna is inserted through the tip of your penis into the tube that carries urine from your bladder (urethra) until he/she reaches the inside of the prostate.  The antenna emits a dose of microwave energy that heats up and destroys excess prostate tissue blocking urine flow.

 

 

Date: 
Wednesday, January 6, 2016 - 17:00