Surgical Treatment For Enlarged Prostate
Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
Open prostatectomy .The surgeon makes an incision and removes the enlarged tissue from the prostate.
Laser surgery –Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
Transurethral incision of the prostate .This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostate’s pressure on the urethra, making urination easier.
Do Laser Treatments Have Any Advantages Over Turp
As well as the standard approaches such as TURP, there are a number of other surgical techniques. They mainly differ in terms of the instruments and sources of energy used to remove or destroy the prostate tissue. Most of the other techniques are carried out using laser beams. Like in TURP, the instruments are inserted into the urethra and guided to the prostate.
The laser treatments include:
- Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med 1995 332: 75-79.
IQWiG health information is written with the aim of helpingpeople understand the advantages and disadvantages of the main treatment options and healthcare services.
Because IQWiG is a German institute, some of the information provided here is specific to theGerman health care system. The suitability of any of the described options in an individualcase can be determined by talking to a doctor. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by ateam ofhealth care professionals, scientists and editors, and reviewed by external experts. You canfind a detailed description of how our health information is produced and updated inour methods.
When Is Bph Treatment Necessary
The course of BPH in any individual is not predictable. Symptoms, as well as objective measurements of urethral obstruction, can remain stable for many years and may even improve over time for as many as one-third of men, according to some studies. In a study from the Mayo Clinic, urinary symptoms did not worsen over a 3.5-year period in 73% of men with mild BPH. A progressive decrease in the size and force of the urinary stream and the feeling of incomplete bladder emptying are the symptoms most correlated with the eventual need for treatment. Although nocturia is one of the most annoying BPH symptoms, it does not predict the need for future intervention.
If worsening urethral obstruction is left untreated, possible complications are a thickened, irritable bladder with reduced capacity for urine infected residual urine or bladder stones and a backup of pressure that damages the kidneys.
- Inadequate bladder emptying resulting in damage to the kidneys
- Complete inability to urinate after acute urinary retention
- Incontinence due to overfilling or increased sensitivity of the bladder
- Bladder stones
- Recurrent severe hematuria
- Symptoms that trouble the patient enough to diminish his quality of life
Find a Location
Currently, the main options to address BPH are:
- Watchful waiting
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What Is Prostate Cancer
Prostate cancer is the most common cancer among American men, right behind skin cancer. Prostate cancer is also the second most deadly cancer in American men. Prostate cancer is more frequent among African American men than it is among white men. Furthermore, African American men are more likely to die of prostate cancer than are white men.
The vast majority of prostate cancers are a type of cancer called adenocarcinoma. Adenocarcinomas arise from cells that produce fluids like mucus.
What Is The Prostate
The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a mans fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
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Vitamin D Deficiency: Health Complications
Additionally, vitamin D deficiency can increase cardiovascular risk factors. Some of them increases the risk of BPH. These parameters are inversely related to prostate volume. In other words, as obesity or hypertension becomes worse, the prostate gland tends to increase.
Another vitamin D deficiency risk that causes prostate enlargement is oxidative stress. In an environment with excess free radicals, the structures of the molecules start to change. The prostate tissue undergoes changes as well and starts to grow in response.
Thats why a recent study evaluated all of these associations, and the authors gave their opinion. They suggest that vitamin D deficiency counts as an independent risk factor for BPH. In other words, you can have normal health, but vitamin D deficiency alone will cause BPH. The authors of this study published in the journal Urology recommend vitamin D as a therapeutic target and a potential marker of BPH .
Similarly, other studies have evaluated the effect of vitamin D levels in the incidence of prostate cancer. The authors report that vitamin D levels are lower in patients with BPH. However, they are still lower in patients with prostate cancer. As vitamin D levels were reduced, the Gleason score and the aggressiveness of cancer increased .
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Causes Of Enlarged Prostate
What exactly causes the enlargement of the prostate is not known. Still, it is said that those who have had their testicles removed at a young age because of a medical condition are not likely to develop benign prostatic hyperplasia . And if a mans testicles are removed after developing BPH, the size of his prostate will start to shrink.
Though the causes for the prostates enlargement are not known, certain factors affect the glands growth as well as the testosterone levels, and these are aging and changes in the cells of the testicles.
Some Facts about Prostate Enlargement
- As men increase in age, the higher the chance that they will develop an enlarged prostate
- BPH is a common condition in men, and it is believed that if they live long enough, it is more likely that they will develop an enlarged prostate
- For men who are over 40 years old, the percentage of those who have an enlarged prostate is small, while those who are more than 80 years old have about 90% with this condition
- Having an enlarged prostate does not mean having risk factors except for the testicles functioning normally
When Should You Call A Doctor For Bph
Urinary symptoms related to enlarging prostate initially affect the quality of life, and if no complications exist, as mentioned above , the decision to treat is optional and is left to the patient. This means that if you don’t feel bothered enough to take a medicine or undergo a procedure for it, you’ll need to follow up with your doctor to ensure the symptoms are stable, and the bladder empties well. This can be assessed by prostate symptom questionnaires and a measure of the strength of the urinary stream and residual urine in the bladder. If complications develop, however, or if the bladder starts holding increasing amounts of residual urine after urination, treatment should be started.
If you experience bladder pain or burning with urination, blood in the urine associated with fever/chills or nausea/vomiting, or if the prostate enlargement condition worsens and symptoms such as blood in the urine or lower back pain are present, consult a doctor immediately. If you cannot reach your doctor when these symptoms are present, seek evaluation at a hospital’s emergency department.
For acute symptoms such as acute urinary retention , you should immediately go to the closest emergency medical facility for bladder drainage, usually with a catheter, which is a tube inserted into the bladder.
Men over 50 years of age should have their prostate checked annually by their physician even if they have no symptoms.
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Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesn’t do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications aren’t developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
New Enlarged Prostate Therapy: Fewer Side Effects
âEmbolizationâ limits prostateâs blood supply, but experts say more research is needed
MONDAY, March 24, 2014 â A new noninvasive procedure may bring long-term relief from symptoms caused by an enlarged prostate, a new study suggests.
As men age, the prostate gland grows larger and may begin to press on the urethra. Enlarged prostate affects more than half of men by age 60 and causes symptoms such as frequent urination, weak urine stream and a persistent feeling of having to urinate.
Surgery is the standard treatment for the condition, but can cause complications such as sexual dysfunction and impotence, experts note.
The new treatment is called prostate artery embolization. âProstate artery embolization is a promising therapy that has been performed outside the United States to improve menâs symptoms,â explained Dr. Man Hon, chief of interventional radiology at Winthrop University Hospital in Mineola, N.Y.
âThis procedure works by closing the blood supply to the prostate,â said Hon, who was not involved in the new study. âAs a result, the prostate shrinks in size, causes less blockage, and the symptoms improve.â
The study was conducted in Portugal and included nearly 500 men, aged 45 to 89, with enlarged prostate â formally called benign prostatic hyperplasia â who underwent prostate artery embolization.
âI believe PAE could eventually become standard treatment for enlarged prostate,â he added.
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What Are Some Reasons For Prostate Problems
It is believed that many prostate related health problems result from anxiety, stress, inactivity . The human body was not designed to sit for extended periods of time. This is one of the reasons why men who work in an office setting often report the most issues with their prostates.
When a man sits for prolonged periods of time, the prostate and the muscles surrounding it become weakened because there is not as much blood circulating in the area. Vital nutrients are not able to reach the prostate, and over time, its function becomes impaired.
Prostate problems are commonly seen in men who are 50 years of age and older. However, for those who have a family history of prostate related problems or have a sedentary lifestyle may notice problems as early as their 30s or 40s.
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
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How To Manage Incontinence
There are multiple ways to manage incontinence:
- Pelvic floor muscle strengthening: Pelvic floor muscle exercises can help muscle strength and bladder control get better by doing exercises that tighten and relax muscles that control the flow of urine.
- Bladder training: This canhelp manage how often you need to urinate throughout the day by assigning certain time intervals to empty your bladder.
- Medicines: Some medications can help the muscles of the bladder and the muscles that control urine flow. Most of these drugs affect either the muscles or the nerves that control them. They work best for urge incontinence.
- Surgery: This may be used to correct long-term incontinence. It can remove blockage. Material such as collagen might be recommended and injected to tighten the muscle that controls urine flow. A small device called a urethral sling can also be implanted to press the urethra against the pubic bone. An artificial muscle controlled by a scrotal pump may be an option for men, and itâs implanted to squeeze the urethra.
- Incontinence products: They can help keep you active and comfortable. Adult briefs and undergarments are bulkier than pads worn under your clothing, but provide more protection. Bed pads or absorbent mattress covers can also be used to protect the bed linens and mattress.
Anorgasmia is the inability to achieve orgasm regardless of the level of stimulation.
2) Penile shrinkage
3) Urine leakage or pain during intercourse
4) Urine leakage at orgasm
Reduced Symptoms And Better Quality Of Life
Men who had the procedure done experienced an improvement in their quality of life and a drop in their symptoms. This was true at one, three, and six months after the procedure.
Men also reported no change in their sexual function, a side effect that may occur with other surgical treatments for enlarged prostate. Two men, however, experienced minor problems after the procedure, including bruising in the groin and a urinary tract infection.
An enlarged prostate can compress the urethra the tube that carries urine from the bladder where it passes through the gland. This can cause symptoms such as frequent or urgent urination, or the inability to completely empty the bladder.
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How Is Benign Prostatic Hyperplasia Diagnosed
Your doctor will look at your medical history and give you a complete physical examination.
Your doctor will perform a digital rectal examination by inserting a gloved, lubricated finger into your rectum to feel the prostate, estimate its size and detect any hard areas that could be cancer.
Several studies may be performed to help diagnose your condition:
- A survey to evaluate how severe your symptoms are.
- A flow study may be conducted to measure how slow the urinary stream is compared with normal urine flow.
- A study to detect how much urine is left in the bladder after you finish urinating.
- A cystoscopy to look into the bladder.
What Are The Side Effects
The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .
Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.
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The Importance Of Prostate Massage
Prostate massage is a treatment that addresses the root cause of most prostate issues. Treatments like surgery and medications only provide temporary relief by treating the symptoms and not the cause.
On the other hand, regular prostate massages encourage the gland to work without problems. A man will not be subjected to dangerous side effects from medication or complications from surgery. Massage also helps make the prostate stronger and more resistant from disease and infection.
Advantages Of Prostate Massage
Although regular prostate massage can help to eliminate or reduce the severity of any symptoms a man may have, it can also offer other benefits especially with improved sexual enjoyment and function.
It is a fact that modern medicine has not been able to determine the causes and treatments for many conditions related to the prostate. Even though prevention is the best medicine, prostate massage will help improve your prostateâs health and prevent existing conditions from becoming worse.
A manâs sexual health is directly related to the health of his prostate. It is common for men with prostate problem to either lose the desire to be intimate due to a painful prostate or experienced burning sensations during the ejaculation process.
However, in the case of bacterial prostatitis, left untreated, can cause intense inflammation and increased bacterial growth.
- | May 30, 2016