As a man grows older, his prostate naturally grows larger. However, there are times when the organ becomes large enough that it may result in urinary tract issues, kidney problems, as well as symptoms such as blocked flow of urine and incontinence. This condition is called benign prostatic hyperplasia or BPH, also called enlarged prostate or prostate gland enlargement. More severe effects of BPH include retention (the inability to pass urine) and renal failure.
The good news is that BPH is benign or noncancerous. At times, it may not even require any treatment at all. However, once the above-mentioned symptoms or complications show up, treatment may be beneficial or even necessary.
If you have BPH, the type of treatment you may need will vary, depending on the severity of the condition. Below are some of your options:
Medications
Many medications can help alleviate or manage the symptoms of BPH. These include:
- Alpha blockers. These can help relax the muscle fibres in the prostate to help make urination easier.
- Tadalafil. Typically used to treat erectile dysfunction, this medication is also useful in treating an enlarged prostate.
- 5-alpha reductase inhibitors. These can shrink the prostate by preventing the hormonal changes that cause the condition. Note that this type of medication may take up to six months to take effect.
In some cases, your doctor may recommend a combination of drugs to treat BPH depending on how you respond to the treatment.
Surgery
If your enlarged prostate results in the blockage of urine flow, you may need surgery to correct the issue. Common procedures include TURP or transurethral resection of the prostate and TUIP or transurethral incision of the prostate. In TURP, the tissue blocking the urethra is removed. In TUIP, on the other hand, the bladder neck and prostate are given small incisions to improve urine flow.
Minimally Invasive Treatments
If your case of BPH isn’t severe but can’t be treated by medications alone, your doctor may suggest undergoing minimally invasive treatments like a prostatic urethral lift. This procedure uses a device that injects thin implants into the sides of the prostate to separate them. As a result, the urethra becomes wider and urination becomes easier.
There is also a process called transurethral electrovaporisation, which uses electrical energy to apply heat to the prostate tissue to eventually vaporise the enlargement. This helps minimise urinary blockage. A similar process is water vapour therapy, which uses an instrument that emits water vapour to produce thermal energy. The produced energy kills prostate cells, which, in turn, shrinks the prostate.
Catheterisation
If you’re awaiting surgery or dealing with infection due to BPH, you may undergo catheterisation. This process is ideal for men who are suffering from both benign prostatic hyperplasia and bladder control problems. Do note that this procedure is temporary and further treatments are needed to address various symptoms.
Laser Therapy
If you have BPH and are also experiencing other illnesses that need certain types of medication, some procedures may not be compatible. In this case, your doctor may recommend laser therapy to destroy the excess prostate tissue.
There are two common options for laser therapy: ablative and enucleative. In an ablative procedure, lasers are used to vaporise the obstructive prostate tissue, resulting in increased urine flow. In an enucleative procedure, all prostate tissue that blocks urine flow will be removed; the laser will also prevent tissue regrowth.
Some examples of ablative procedures include photoselective vaporisation of the prostate or PVP, and holmium laser ablation of the prostate or HoLAP. Meanwhile, enucleative procedures include holmium laser enucleation of the prostate or HoLEP.
Prostatectomy
If you have a severely enlarged prostate, you may need to undergo a prostatectomy. This procedure is usually conducted through laparoscopic or robotic-assisted surgery to remove the entire prostate.
What to Do After Treatment
For cases of BPH that can be managed with medication, it’s important to keep up with the prescription to ensure continued good results. If you need to undergo surgeries or other treatment procedures, make sure to follow after-care instructions. Your condition will improve quickly, but you should always watch out for side effects like bleeding, erectile dysfunction, and incontinence.
For those who are sexually active, expect to wait a while for sexual function to return. It should also be noted that one of the side effects of most BPH treatments is retrograde ejaculation, a condition in which the semen enters the bladder instead of exiting out of the penis. While it doesn’t affect sexual performance, it may result in infertility. This is crucial information if you’re planning on having children in the future.
BPH is not a lethal disease, although it can affect your quality of life. Immediate treatment is advisable to make sure that your symptoms don’t worsen. Men are also recommended to undergo regular health check-ups once they reach a certain age for proper diagnosis of such diseases. Considering that BPH can co-occur with cancer, early detection is even more important.
