BPH treatment can involve monitoring, medication, or surgery for an enlarged prostate.
When an enlarged prostate is compressed or blocks the tube that carries urine from the bladder out of the body (urethra), it’s a treatable condition known as benign prostatic hyperplasia (BPH). This non-cancerous condition is more likely to occur in older men due to the natural enlargement of the prostate that occurs with age.
Since there are many issues that can cause problems with urine flow and urination frequency, patients showing signs of BPH are often referred a urologist for further evaluation and treatment.
The type of treatment recommended will depend on factors such as overall health, the size of the enlarged prostate, and the severity of symptoms. If disruption to urine flow is minimal or not a serious issue, periodic monitoring may be all that’s necessary. In some cases, symptoms naturally ease with little or no intervention.
The most common treatment for BPH involves medication to manage symptoms. Alpha blockers (alpha-adrenergic antagonists) work by relaxing muscle tissues in the bladder and prostate. The purpose of 5-alpha reductase inhibitors is to reduce the size of the prostate by blocking the hormonal changes that cause the gland to grow.
Depending on the severity of symptoms and the size of the prostate, a urologist may recommend a combination of more than one medication. There’s also research suggesting that an erectile dysfunction medication (tadalafil) may be effective for BPH treatment.
If medication isn’t effectively managing symptoms, surgery may become an option. Surgery for BPH may also be recommended if a patient’s enlarged prostate is contributing to issues with bladder stones, kidney problems, or an obstruction in the urinary tract. There are several minimally invasive procedures that may be considered.
Transurethral Resection of the Prostate: With this procedure, most of the prostate gland is removed through a special lighted tool inserted through the urethra. The outermost part of the gland remains in place. A catheter is sometimes temporarily needed post-surgery to help with bladder drainage.
Transurethral Incision of the Prostate: Also performed with a scope, this procedure involves one or two cuts in the prostate gland to provide a better passageway for urine. This procedure may be done on patients not able to have other surgical treatments due to health risks.
TUMT and TUNA: Both transurethral microwave thermotherapy (TUMT) and transurethral needle ablation (TUNA) involve the use of waves delivered with special instruments inserted into the urethra. With TUMT, microwave energy is used to shrink the prostate by destroying the inner part of it. With TUNA, radio waves are administered to the gland to destroy excess prostate tissue.
Other BPH Treatments
Prostate tissue is sometimes removed with laser therapy with a high-energy laser that’s applied to certain parts of the gland. If a prostate lift is done, the sides of the gland are compressed to improve urine flow. With embolization, blood flow to the prostate is blocked in certain areas to shrink the gland. For men with a significantly enlarged prostate, a robot-assisted or traditional open prostatectomy may be done to remove all or part of the prostate.
Even when the only recommended treatment is periodic monitoring, it’s important for patients with BPH to pay attention to changes in symptoms that might occur as the prostate further enlarges. BPH isn’t considered a preventable condition. However, taking steps to maintain good prostate health, such as eating selenium-rich foods like seafood and wheat germ, getting regular urinary system and prostate exams, and maintaining a healthy weight, may minimize the risk of experiencing problems related to this gland.