Benign Prostatic Hyperplasia
Complete BPH care—from medications to minimally invasive procedures and surgery—available across Texas.
As the prostate enlarges and encroaches on the urethra, a multitude of symptoms may develop. Obstructive symptoms such as difficulty starting urinary flow, double-voiding, weak stream, dribbling, and a sensation of incomplete emptying may occur. Irritative symptoms may also occur, which include frequency, urgency, and getting up at night to urinate. A thorough history and physical exam are important in diagnosing BPH. A prostate specific antigen (PSA), and possibly a urine flow and assessment of residual urine with a bladder ultrasound, may be necessary to assess the severity of the symptoms. An American Urologic Association assessment questionnaire will help quantify the degree of voiding difficulty.
BPH treatment options include medication for some men, while others with severe symptoms and inability to urinate (urinary retention) often require a minimally invasive or surgical procedure to allow the urine to flow better through the prostate. Some procedures are performed on an outpatient basis while others require up to two days in the hospital.
Your physician can help you decide which treatment for benign prostatic hyperplasia (BPH) is right for you. Medications are a good option for many men. A few of the more common types of medications include:
This type of medication improves urine flow by relaxing the muscles of the prostate and bladder neck. While alpha blockers reduce blockage and symptoms of BPH, they do not reduce the size of the prostate.
Alpha blockers work immediately. Side effects include dizziness, lightheadedness, fatigue, and difficulty ejaculating. This treatment may be suitable for men with moderate to severe BPH. However, men about to have cataract surgery should avoid this option.
This type of medication blocks the production of dihydrotestosterone (DHT), a male hormone involved in prostate development and growth. As DHT accumulates in the prostate, it can cause the prostate to grow. 5-alpha reductase inhibitors increase urine flow, prevent further growth, and reduce the size of the prostate.
These medications can lower risk of BPH complications and reduce the need for surgery. Side effects include erectile dysfunction and low sex drive. Also, men must keep taking the medication to prevent symptoms. This type of medication may be best for men with very large prostate glands and older men.
Sometimes an alpha blocker and a 5-alpha reductase inhibitor are used together to effectively improve symptoms. Some options are available in a single tablet.
For some men, alpha blockers and 5-alpha reductase inhibitors work better together than either one alone. However, they can be increased side effects. This treatment is often used for men with larger prostates.
Your physician can help you decide which treatment for benign prostatic hyperplasia (BPH) is right for you. Minimally invasive treatments are a good option for many men. A few of the more common types of procedures include:
The transurethral needle ablation (TUNA) is a minimally invasive procedure to treat benign prostatic hyperplasia (BPH). It uses radiofrequency waves to heat and destroy tissue of the enlarged prostate. After inserting a cystoscope through the urethra to reach the prostate, small needles are inserted through the scope to send high-frequency radiowaves to destroy the tissue. The procedure uses local anesthesia and is performed in the physician’s office. Doctors use shields to protect the urethra from heat damage. This procedure can be a good option for men with other medical conditions, weak hearts, or who need to avoid anesthesia.
Used to treat benign prostatic hyperplasia (BPH), transurethral microwave thermotherapy (TUMT) uses an antenna to send microwaves through a catheter to heat and destroy prostate tissue. A minimally invasive procedure, the thermotherapy is performed on an outpatient basis in about an hour, without general anesthesia, using a cooling system to protect the urinary tract. Erectile dysfunction and incontinence are not typical side effects of TUMT. Microwave therapy does not eliminate BPH, but it does reduce urgency, urinary frequency, and straining. This procedure can be a good option for men with other medical conditions, weak hearts, or who need to avoid anesthesia.
Transurethral electrovaporization (TUVP) is a minimally invasive procedure in which physicians use an electric current to destroy prostate tissue. It is used to treat benign prostatic hyperplasia (BPH). A doctor inserts a scope which passes over the prostate to destroy tissue and seal blood vessels to reduce the risk of bleeding. A short hospital stay may be needed. Men with larger prostates are candidates for this procedure.
In this minimally invasive procedure used to treat benign prostatic hyperplasia (BPH), prostate stents are placed in the bladder neck and prostatic urethra. They keep the prostatic urethra from collapsing and allow urine to drain from the bladder. Placed in the narrowed area caused by the enlarged prostate, the stent expands like a spring to keep the urethra open for urine flow. There are two types of prostatic stents, temporary and permanent. Patients may notice mild discomfort and increased urination. This procedure is often used for men who are not candidates for surgery.
Your physician can help you decide which treatment for benign prostatic hyperplasia (BPH) is right for you. Surgical treatments are a good option for many men. A few of the more common types of procedures include:
Transurethral resection of the prostate (TURP) is a type of prostate surgery to alleviate severe symptoms from benign prostatic hyperplasia (BPH). No incisions are needed in transurethral resection of the prostate (TURP). A physician uses an instrument called a resectoscope through the urethra to reach the prostate. The surgeon uses the scope’s electrical loop to cut and remove the obstructing tissue one piece at a time. The pieces of tissue are carried by fluid into the bladder and then flushed out of the body. The TURP procedure requires a temporary catheter and short hospital stay. It is the most common surgery for BPH.
In laser surgery for benign prostatic hyperplasia BPH, a laser fiber is passed into the urethra near the prostate using a cystoscope. Then, several bursts of energy are delivered through the laser fiber, which vaporizes the prostate tissue. No incisions are needed. There is little blood loss because blood vessels are sealed during the treatment. However, laser surgery may not be effective on very large prostates. A temporary catheter and short hospital stay are needed.
Used to treat benign prostatic hyperplasia BPH, transurethral incision of the prostate (TUIP) is similar to transurethral resection of the prostate (TURP). Instead of removing tissue, doctors make the urethra bigger with a few tiny cuts in the bladder neck, where the urethra joins the bladder, and in the prostate. A physician inserts a cystoscope into the urethra and uses an electric current or laser beam to widen the urethra to enable better urine flow. No incisions are needed. A temporary Foley catheter and short hospital stay is needed. This procedure is often used for men who have a smaller prostate but serious blockage and men who need surgery but do not want to remove the prostate completely.
