Treatment of Benign Prostatic Hyperplasia
The treatment of BPH involves the following-
This treatment option is good for patients who have mild symptoms of BPH and are not bothered by their symptoms. During watchful waiting, a patient is closely monitored by the urologist but does not receive any active treatment. Yearly check-ups and findings from the tests help determine if additional treatment is needed in order to control a patient’s BPH.
Alpha blockers like alfuzosin, terazosin, doxazosin or tamsulosin work by relaxing the smooth muscle of the prostate and bladder to improve urine flow and reduce bladder outlet obstruction. Although they may relieve the symptoms of BPH, they usually do not reduce the size of the prostate.
5-alpha-reductase inhibitors like finasteride and dutasteride can relieve BPH symptoms, increase urinary flow rate and shrink the prostate though it must be used indefinitely to prevent symptoms. These drugs also reduce the risk of BPH complications.
Combination Therapy- The use of both alpha blockers and 5-alpha-reductase inhibitors prevents the progression of disease and improves bothersome symptoms.
Surgery is reserved for patients suffering from moderate to severe complications which arise from BPH (e.g. urinary retention or recurrent urine infection), and who have not been able to successfully treat the condition with other treatment options. There are two types of surgery to remove excess prostate tissue-
Trans-urethral resection of prostate (TURP) - This is an endoscopic procedure and usually a spinal or epidural anesthesia may be given for this surgery. It is the most common type of surgery undertaken for an enlarged prostate gland. During this procedure an instrument is inserted through the penis to allow the doctor to see and remove any tissue blocking the urinary passage called the urethra.
Open prostatectomy- May be done when a large amount of tissue must be removed or when the size, shape or position of the prostate makes it necessary. An incision is made in the abdomen or the area between the anus and scrotum and the excess tissue is removed.