What Are The Types Of Prostate Surgery For Benign Prostatic Hyperplasia
Several minimally invasive surgeries may be used for benign prostatic hyperplasia. These include:
GreenLight laser: Photoselective vaporization of the prostate is a treatment that vaporizes prostate tissue to create a channel in the urethra for free urination. This is surgical treatment performed in the operating room under general anesthesia.
Plasma button electrovaporization: Prostate tissue is removed using low temperature plasma energy. Tissue is vaporized. This is an operating room-based therapy and requires an anesthetic.
Water vapor therapy : Water vapor is directly delivered to the prostate tissue. Over a 3-month period the tissue is destroyed and reabsorbed by the body. This is an office-based therapy and is performed under a local nerve block.
UroLift®: A mechanical approach that places implants to pin the lateral prostate lobes out of the way to reduce obstruction. This is an office-based procedure performed under a local nerve block.
Prostatic artery embolization: This approach uses catheters to deliver agents that block blood flow to the prostatic artery to reduce symptoms of BPH by shrinking tissue. This prostate procedure uses local anesthesia and doesnt require a hospital stay.
How Should This Medicine Be Used
Tamsulosin comes as a capsule to take by mouth. It is usually taken once a day. Take tamsulosin 30 minutes after the same meal each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tamsulosin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow tamsulosin capsules whole do not split, chew, crush, or open them.
Your doctor will probably start you on a low dose of tamsulosin and may increase your dose after 2 to 4 weeks.
Tamsulosin may help control your condition, but it will not cure it. Continue to take tamsulosin even if you feel well. Do not stop taking tamsulosin without talking to your doctor.
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What Is The Outlook For Men Who Have Benign Prostatic Hyperplasia Surgery
Benign prostatic hyperplasia surgery has a very high success rate. However, for the best results from treatment, you should seek medical help at the earliest signs of a problem. Also, talk with a doctor if you are experiencing symptoms of BPH after surgery.
There is no evidence that BPH increases the risk of developing prostate cancer. However, the symptoms of BPH and prostate cancer are similar. The American Urological Association and the American Cancer Society recommend annual prostate screenings for men ages 55 to 69. Men at high risk such as African-American men and men with a family history of prostate cancer should begin screening at age 40.
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Diagnosis Of An Enlarged Prostate
The doctor will ask some detailed questions about the symptoms and by doing a physical exam. This will include:
- Urine test: The doctor will analyze the sample of your urine which can help to detect the infection or conditions which can cause the symptoms.
- Blood test: This will indicate kidney problems
- Digital rectal exam: The doctor here inserts a finger into the rectum to check for prostate enlargement
If the condition is bad, the doctor will recommend:
- Prostate biopsy: In transrectal ultrasound, needles are used to take some tissue samples of the prostate. By examining the tissue, the doctor can determine the problem.
- Cystoscopy: This is a lighted, flexible instrument which is inserted into the urethra, which allows the doctor to see the inside of the bladder. The doctor will give the anesthesia.
- Transrectal ultrasound: An ultrasound probe is inserted in the rectum to measure and examine your prostate.
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What If You Have Metastatic Hormone
If your doctor tells you that you have this type of metastatic prostate cancer, it means your cancer responds to hormone therapy
Most prostate cancer cells need male sex hormones, including androgens like testosterone, to grow. A type of hormone therapy like androgen deprivation therapy could slow the growth of mHSPC by lowering the level of these hormones.
You could also ask your doctor if youââ¬â¢re eligible for any clinical trials.
Still, some people with mHSPC prefer to avoid or delay getting treatment with an option called active surveillance. Thatââ¬â¢s when your doctor keeps close tabs on your health but doesnââ¬â¢t give you treatment unless test results show your cancer is getting worse.
You could ask your doctor if watchful waiting is an option for you.
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.
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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.
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Diagnosis Of Prostatic Enlargement
Diagnosis of prostatic enlargement/ BPH is done through:
The physician may ask for lab tests to estimate the condition or to help him identify the underlying cause. they include:
Urine analysis.
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What Are The Chances Of Getting Metastatic Prostate Cancer
About 50% of men diagnosed with local prostate cancer will get metastatic cancer during their lifetime. Finding cancer early and treating it can lower that rate.
A small percentage of men aren’t diagnosed with prostate cancer until it has become metastatic. Doctors can find out if it’s metastatic cancer when they take a small sample of the tissue and study the cells.
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What Happens During Surgery
The aim of surgery is to make the prostate gland smaller so that it no longer pushes against the bladder and urethra. In most of the approaches, tiny instruments are guided through the urethra until they reach the prostate, where they are used to remove tissue or widen the urethra. This kind of procedure is known as keyhole surgery. If the prostate gland is very large, it may be operated on from the outside, through a cut in the abdominal wall . This is rarely necessary, though.
Many different surgical techniques and many different instruments and devices can be used to remove prostate tissue in different ways.
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Nonsurgical Treatment For Benign Prostatic Hyperplasia
If youre a man over 50, you have a one in three chance of having benign prostatic hyperplasia , the most common benign tumor found in men. BPH causes symptoms such as lack of bladder control, increased urinary frequency, and urgency and pain. For those with minor symptoms, medication or diet changes can help, but as symptoms increase, surgery is often the next step.
But for men who are not candidates for surgery, or have a strong desire to avoid surgery, prostatic artery embolization is a new treatment option.
Interventional radiologist Brian Holly, M.D. , explains what you should know about the prostatic artery embolization procedure and if it may be right for you.
What Happens After Treatment
If you’ve been treated, especially if a surgeon removed your prostate, your PSA levels should start to go down. Doctors usually wait several weeks after surgery before checking PSA levels.
A rise in PSA after treatment may suggest the cancer is back or spreading. In that case, your doctor may order the same tests used to diagnose the original cancer, including a CT scan, MRI, or bone scan. The radiotracer Axumin could be used along with a PET scan to help detect and localize any recurrent cancer.
Though very rare, it’s possible to have metastatic prostate cancer without a higher-than-normal PSA level.
Go to all of your follow-up doctor appointments. At these checkups, let your doctor know about any symptoms youââ¬â¢re having, especially ones like bone pain or blood in your pee. You could keep track of your symptoms by writing them down in a journal or diary.
At home, follow some healthy habits to feel your best:
Eat a balanced diet. It can boost your energy and your immune system. Fill your plate with fruits and vegetables and high-fiber foods. Cut back on fattening foods, sugar, and processed foods and meats.
Let your doctor know if youââ¬â¢re having trouble staying at a healthy weight or if youââ¬â¢re losing your appetite.
Get exercise if your doctor OKs it. It can be good for your body and mind. It can also help you stay at a healthy weight, keep up your strength, and help manage medication side effects.
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Understanding The Importance Of Your Prostate
Your prostate can become larger as you age, and usually begins to grow around the age of 40-50 this is a normal part of aging. Eventually, this growth can lead to Benign Prostatic Hyperplasia, better known as BPH.
As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:
- Frequent need to urinate both day and night
- Weak or slow urinary stream
- A sense that you cannot completely empty your bladder
- Difficulty or delay in starting urination
- Urgent feeling of needing to urinate
- A urinary stream that stops and starts
If you suffer from the above symptoms, you are not alone. BPH is the leading reason men visit a urologist.3
Questions To Ask Before Surgery
As you think over the options for surgery, ask your doctor these questions:
- Is there a good chance my condition will get better?
- How much will it improve?
- What are the chances of side effects from a treatment?
- How long will the effects last?
- Will I need to have this treatment repeated?
With newer technologies, doctors can do some minimally invasive procedures with tiny cuts or use tube-style instruments that they insert into you. These procedures may not treat the symptoms to the same degree or durability as more invasive surgical options, they do have faster recoveries, less pain afterward and have reduced risks.
Other times, the traditional and more invasive surgery may be needed. It all depends on your case and what you and your doctor decide is best for you.
Doctors can choose from these minimally invasive procedures, endoscopic, or open surgeries to treat moderate to severe symptoms. These procedures are also used if tests show that your ability to pee is seriously affected.
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Why The Procedure Is Performed
An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate gland can make these symptoms better. Before you have surgery, your doctor may tell you changes you can make in how you eat or drink. You may also try some medicines.
Your doctor may recommend prostate removal if you:
- Cannot completely empty your bladder
- Have repeat urinary tract infections
- Have bleeding from your prostate
- Have bladder stones with your enlarged prostate
- Urinate very slowly
- Took medicines and they did not help your symptoms
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New Minimally Invasive Treatment For Enlarged Prostate Shows Promise
University of Arizona interventional radiologists and urologists at Banner University Medical Center Tucson have been working to improve the quality of life in men with benign prostatic hyperplasia .
BPH, also known as an enlarged prostate, affects as many as half of men by age 60. Symptoms include urinary frequency, urgency, urination at night that disrupts sleep and incomplete bladder emptying.
Now, for the first time in Southern Arizona, physicians at Banner UMC are offering a new, non-surgical outpatient procedure — prostate arterial embolization — for this common condition.
Historically, patients who have suffered from urinary problems stemming from an enlarged prostate have only had the option of surgery, said Hugh McGregor, MD, assistant professor in the UA Department of Medical Imaging. PAE utilizes the newest technology and achieves relief of symptoms in 85 percent of men, with minimal side effects and a quick recovery, he said.
PAE is performed as an outpatient procedure with a local anesthetic. Doctors work through an incision the size of a pinhole to decrease the size of the enlarged prostate gland, Dr. McGregor said, adding that recovery time with PAE is minimal compared to the six weeks commonly required after the traditional surgical option known as TURP .
Dr. McGregor added that sexual side effects, a risk in traditional TURP surgery, are minimal in PAE.
About Banner University Medical Center Tucson and South
What To Expect And Side Effects Of Rezm
Following the procedure, your doctor prescribes pain medication for your recovery. Most patients return to regular activities within a few days following treatment. The main precaution following the procedure is limiting strenuous activity until the catheter is removed.
In a majority of cases, individuals are able to fully recover from the procedure within a few days to a week. Improvement in BPH symptoms is often noted within a few weeks, and after three months, most individuals feel a complete relief from symptoms.
Rezm has fewer side effects compared to surgical therapies. Potential side effects are similar to symptoms of BPH, such as frequent or painful urination, inability to urinate or to completely empty the bladder, and blood in the urine. However, most potential side effects are usually mild to moderate and typically resolve within several weeks following Rezm. Your urologist will give instructions on how to prevent or manage any symptoms. If symptoms recur in the future, the treatment can be repeated.
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What Is Aquablation Therapy
Aquablation therapy is one of several surgical treatments available to treat BPH.
It’s an incision-less procedure that uses an image-guided robotic arm. The arm holds a water jet to very precisely remove excess prostate tissue.
“Since we enter through a natural orifice, the urethra, there are no incisions during this procedure,” Dr. Gonzalez explains. “And the use of image-guided robotics means tissue is removed with great precision.”
This reduces post-operative pain and speeds up recovery, compared to traditional surgical approaches.
“One of the amazing things about aquablation therapy is that patients experience little to no pain,” Dr. Gonzalez adds. “There’s some mild discomfort after surgery, at max perhaps a 3 out of 10 on the pain scale and that number should quickly drop.”
Additionally, because the tissue is removed using room-temperature saline water, the blockage can be fixed without harming or burning the prostate tissue that remains. Saline water is biocompatible with the human body.
“Several other surgical prostate therapies destroy excess tissue using heat or harsh substances, both of which can harm the remaining tissue and likely contribute to some of the sexual dysfunction seen after those procedures,” explains Dr. Gonzalez.
The procedure, performed while the patient is under anesthesia in an operating room, typically takes about 45 minutes, almost half as long as traditional prostatectomy.