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Contents
Procedure description: Benign Prostatic Hyperplasia Treatments
Patient preparation: Benign Prostatic Hyperplasia Treatments
Recovery: Benign Prostatic Hyperplasia Treatments
Note: Benign Prostatic Hyperplasia Treatments
Conditions: Benign Prostatic Hyperplasia Treatments
Common Synonyms: Benign Prostatic Hyperplasia Treatments
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| Procedure description: Benign Prostatic Hyperplasia Treatments |
Benign prostatic hyperplasia is not simply a case of too many prostate cells. Prostate growth involves hormones, occurs in different types of tissue (e.g., muscular, glandular), and affects men differently. As a result of these differences, treatment varies in each case. There is no cure for BPH and once prostate growth starts, it often continues, unless medical therapy is started.
Benign prostatic hyperplasia affects more than 50% of men over age 60 and as many as 90% of men over the age of 70.
Treatment options for enlarged prostate, or benign prostatic hyperplasia , may include the following: Medical , Watchful waiting ,
Medications (e.g., alpha blockers) , Prostatic stents , Minimally invasive treatments (thermotherapy) , Laser , Microwave , Surgical treatments , Transurethral resection of the prostate , Holmium laser enucleation of the prostate , Prostatectomy , Transurethral incision of the prostate , Transurethral ultrasound-guided laser incision of the prostate .
Surgical treatment involves removing the enlarged part of the prostate that constricts the urethra. It is recommended for patients who experience serious complications, such as the following: bleeding through the urethra as a result of benign prostatic hyperplasia, damage to the kidneys caused by urine backing up, frequent urinary tract infections , inability to urinate , stones in the bladder
Transurethral resection of the prostate (TURP) is the gold standard to which other surgeries for benign prostatic hyperplasia are compared. This procedure is performed under general or regional anesthesia and takes less than 90 minutes.
Holmium laser enucleation of the prostate (HoLEP) produces results that are similar to TURP with fewer complications (e.g., less intraoperative bleeding). HoLEP is usually performed as a day procedure in the hospital. Benefits of HoLEP over traditional surgery is significant.
If the prostate is greatly enlarged, if the bladder has been damaged, or if the patient has complications prohibiting transurethral surgery, prostatectomy (removal of the obstructing prostate) may be necessary. This procedure is sometimes the best and safest approach.
Transurethral incision of the prostate (TUIP) may be recommended to treat a prostate that is not greatly enlarged. The surgeon makes one or more cuts in the bladder neck where the urethra joins the bladder, extending into the prostate. This reduces the prostate's pressure on the urethra and makes urination easier. TUIP may provide relief with a lower incidence of retrograde ejaculation than TURP. However, its long-term benefits and risks compared to TURP have not been established.
TULIP
Transurethral ultrasound-guided laser incision of the prostate (TULIP) is a new procedure that is similar to TUIP, except that the cuts are made with a laser.
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| Patient preparation: Benign Prostatic Hyperplasia Treatments |
A physical examination, patient history, and evaluation of symptoms provide the basis for a diagnosis of benign prostatic hyperplasia. The physical examination includes a digital rectal examination.
Blood tests taken to check the levels of prostate specific antigen (and prostatic acid phosphatase in a patient who may have benign prostatic hyperplasia helps the physician eliminate a diagnosis of prostate cancer.
Patients with benign prostatic hyperplasia or prostatitis produce larger amounts of PSA. The PSA level also is determined in part by the size and weight of the prostate.
Urodynamic tests, usually performed in a physician's office, are used to measure the volume and pressure of urine in the bladder and to evaluate the flow of urine. They are particularly useful for the diagnosis of Intrinsic sphincter deficiency and uncertain cases of mixed, overflow, urgency, or total incontinence. Additional tests may be conducted if symptoms indicate that blockage is caused by a condition other than benign prostatic hyperplasia.
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| Recovery: Benign Prostatic Hyperplasia Treatments |
After prostate surgery, a urinary catheter is inserted to ensure bladder emptying. Urine output and color and continuous bladder irrigation (CBI), if present, are monitored. Blood in the urine is an expected side effect of prostate surgery. CBI is used to maintain the effectiveness of the urinary catheter, remove blood clots, and cleanse the surgical area. If bladder spasms occur, the surgeon should be notified.
Once they have been discharged from the hospital, patients should abstain from sexual intercourse for 6 weeks after surgery. Strenuous activity and lifting is to be avoided throughout the recovery period, which can take up to 8 weeks.
Potential complications include incontinence and impotence. Depending on the procedure, stress urinary incontinence may result when pressure is put on abdominal muscles. Urge incontinence and involuntary passing of urine while asleep also may occur. Patients are encouraged to use Kegel exercies to strengthen pelvic floor muscles and to increase their water intake. Ejaculatory and erectile dysfunction (impotence) may occur, depending on the procedure. |
| Note: Benign Prostatic Hyperplasia Treatments |
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| Conditions: Benign Prostatic Hyperplasia Treatments |
| enlarged prostate , benign prostatic hyperplasia |
| Common Synonyms: Benign Prostatic Hyperplasia Treatments |
| prostate surgery , prostatectomy |
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