Benign Prostatic Hyperplasia
The prostate is a gland which provides nutrients for sperm, and is located just below the bladder. Urine passes from the bladder into a tube (the urethra) which goes through the the prostate gland and into the penis. About age 30, the prostate can begin to undergo benign (non-cancerous) growth. The growth is slow, but continuous. As the prostate enlarges, it may block the urethra, which would interfere with the bladder's ability to empty completely. Benign prostatic hyperplasia (BPH) is fairly common - up to 90% of 80 year old men have some degree of BPH.
Signs and symptoms
Signs and symptoms of BPH can include, but are not limited to:
BPH is not prostate cancer and does not lead to prostate cancer; however, some of the signs and symptoms of BPH and prostate cancer might be similar. It is important to see a urologist if you have any of the above symptoms.
Once the diagnosis of BPH is made, treatment will depend on the severity of the symptoms. There are three basic treatment options: medication, minimally invasive techniques, and surgery.
Medications to shrink the size of the prostate by lowering the levels of the hormone (testoterone) which is responsible prostate growth. Finasteride (Proscar) or is an example of this type of medication.
Medications to relax the smooth muscle in the prostate and bladder neck, which make it easier for urine to pass through the prostate. Tamsulosin (Flo-Max) or Terazosin (Hytrin)are examples of this type of medication.
Minimally invasive technique
Transurethral microwave thermo-therapy (TUMT); Interstitial laser therapy; Transurethral needle ablation (TUNA)
The common feature of these minimally invasive treatments is that energy (heat) is applied to the prostate to destroy the prostate tissue that immediately surrounds the urethra. This makes the urethra wider as it passes through the prostate, and allows the patient to urinate more easily. These treatments are outpatient procedures, so there is no overnight hospital stay. In general, these treatments are effective, but not as effective as transurethral resection of the prostate (TURP).
The enlarged central portion of the prostate can be removed through the urethra - transurethral resection of the prostate (TURP), or by an abdominal wall incision (open prostatectomy). Unless the prostate gland is particularly large, all cases of BPH can be treated by TURP. For a TURP, a small scope is placed in the urethra and the prostate is "cored out" to enlarge the channel. These procedures provide the most dramatic improvement in voiding. Even though the prostate will continue to gradually grow, TURP and open prostatectomy are the most lasting of BPH treatments.