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Treatments for Enlarged prostate

Treatment List for Enlarged prostate

The list of treatments mentioned in various sources for Enlarged prostate includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

  • See treatment of Benign Prostate Hyperplasia
  • See treatment of prostate cancer
  • Patients with mild symptoms of benign prostatic hyperplasia or moderate-to-severe symptoms who are not bothered by their symptoms and are not manifesting secondary signs of complications of BPH should be managed with a strategy of watchful waiting
  • Transurethral resection of the prostate (TURP) has long been accepted as the criterion standard for relieving bladder outlet obstruction (BOO) secondary to BPH
  • Medications- finasteride, Dutasteride

Alternative Treatments for Enlarged prostate

Alternative treatments or home remedies that have been listed as possibly helpful for Enlarged prostate may include:

Enlarged prostate: Marketplace Products, Discounts & Offers

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Enlarged prostate: Research Doctors & Specialists

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Latest treatments for Enlarged prostate:

The following are some of the latest treatments for Enlarged prostate:

  • Interstitial laser coagulation
  • High frequency focused ultrasound
  • Transurethral needle ablation
  • Transurethral microwave thermotherapy
  • Water induced thermotherapy
  • Prostate stenting
  • Transurethral ethanol ablation
  • Trans urethral resection of the prostate
  • Open prostatectomy
  • Transurethral laser ablation
  • Transurethral vaporization of prostate

Hospital statistics for Enlarged prostate:

These medical statistics relate to hospitals, hospitalization and Enlarged prostate:

  • 0.32% (41,029) of hospital consultant episodes were for hyperplasis of prostate in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 95% of hospital consultant episodes for hyperplasis of prostate required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 100% of hospital consultant episodes for hyperplasis of prostate were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • 10% of hospital consultant episodes for hyperplasis of prostate required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
  • more hospital information...»

Hospitals & Medical Clinics: Enlarged prostate

Research quality ratings and patient incidents/safety measures for hospitals and medical facilities in specialties related to Enlarged prostate:

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Choosing the Best Treatment Hospital: More general information, not necessarily in relation to Enlarged prostate, on hospital and medical facility performance and surgical care quality:

Medical news summaries about treatments for Enlarged prostate:

The following medical news items are relevant to treatment of Enlarged prostate:

Discussion of treatments for Enlarged prostate:

Men who have BPH with symptoms usually need some kind of treatment at some time. However, a number of recent studies have questioned the need for early treatment when the gland is just mildly enlarged. These studies report that early treatment may not be needed because the symptoms of BPH clear up without treatment in as many as one-third of all mild cases. Instead of immediate treatment, they suggest regular checkups to watch for early problems. If the condition begins to pose a danger to the patient's health or causes a major inconvenience to him, treatment is usually recommended.

Since BPH may cause urinary tract infections, a doctor will usually clear up any infection with antibiotics before treating the BPH itself. Although the need for treatment is not usually urgent, doctors generally advise going ahead with treatment once the problems become bothersome or present a health risk.

The following section describes the types of treatment that are most commonly used for BPH.

Drug Treatment

Over the years, researchers have tried to find a way to shrink or at least stop the growth of the prostate without using surgery. Recently, several new medications have been tested in clinical trials, and the Food and Drug Administration (FDA) has approved four drugs to treat BPH. These drugs may relieve common symptoms associated with an enlarged prostate.

Finasteride (marketed under the name Proscar), FDA-approved in 1992, inhibits production of the hormone DHT, which is involved with prostate enlargement. Its use can actually shrink the prostate in some men.

FDA also approved the drugs terazosin (marketed as Hytrin) in 1993, doxazosin (marketed as Cardura) in 1995, and tamsulosin (marketed as Flomax) in 1997 for the treatment of BPH. All three drugs act by relaxing the smooth muscle of the prostate and bladder neck to improve urine flow and to reduce bladder outlet obstruction. Terazosin, doxazosin, and tamsulosin belong to the class of drugs known as alpha blockers. Terazosin and doxazosin were developed first to treat high blood pressure. Tamsulosin is the first alpha blocker developed specifically to treat BPH.

Nonsurgical Treatment

Because drug treatment is not effective in all cases, researchers in recent years have developed a number of procedures that relieve BPH symptoms but are less invasive than surgery.

Transurethral Microwave Procedures.In May 1996, FDA approved the Prostatron, a device that uses microwaves to heat and destroy excess prostate tissue. In the procedure called transurethral microwave thermotherapy (TUMT), the Prostatron sends computer-regulated microwaves through a catheter to heat selected portions of the prostate to at least 111 degrees Fahrenheit. A cooling system protects the urinary tract during the procedure.

A similar microwave device, the Targis System, received FDA approval in September 1997. Like the Prostatron, the Targis System delivers microwaves to destroy selected portions of the prostate and uses a cooling system to protect the urethra. A heat-sensing device inserted in the rectum helps monitor the therapy.

Both procedures take about 1 hour and can be performed on an outpatient basis without general anesthesia. Neither procedure has been reported to lead to impotence or incontinence.

While microwave therapy does not cure BPH, it reduces urinary frequency, urgency, straining, and intermittent flow. It does not correct the problem of incomplete emptying of the bladder. Ongoing research will determine any long-term effects of microwave therapy and who might benefit most from this therapy.

Transurethral Needle Ablation. In October 1996, FDA approved Vidamed's minimally invasive Transurethral Needle Ablation (TUNA) System for the treatment of BPH.

The TUNA System delivers low-level radiofrequency energy through twin needles to burn away a well-defined region of the enlarged prostate. Shields protect the urethra from heat damage. The TUNA System improves urine flow and relieves symptoms with fewer side effects when compared with transurethral resection of the prostate (TURP). No incontinence or impotence has been observed.

Surgical Treatment

Most doctors recommend removal of the enlarged part of the prostate as the best long-term solution for patients with BPH. With surgery for BPH, only the enlarged tissue that is pressing against the urethra is removed; the rest of the inside tissue and the outside capsule are left intact. Surgery usually relieves the obstruction and incomplete emptying caused by BPH. The following section describes the types of surgery that are used.

Transurethral Surgery. In this type of surgery, no external incision is needed. After giving anesthesia, the surgeon reaches the prostate by inserting an instrument through the urethra.

A procedure called TURP (transurethral resection of the prostate) is used for 90 percent of all prostate surgeries done for BPH. With TURP, an instrument called a resectoscope is inserted through the penis. The resectoscope, which is about 12 inches long and 1/2 inch in diameter, contains a light, valves for controlling irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels.

During the 90-minute operation, the surgeon uses the resectoscope's wire loop to remove the obstructing tissue one piece at a time. The pieces of tissue are carried by the fluid into the bladder and then flushed out at the end of the operation.

Most doctors suggest using TURP whenever possible. Transurethral procedures are less traumatic than open forms of surgery and require a shorter recovery period.

Another surgical procedure is called transurethral incision of the prostate (TUIP). Instead of removing tissue, as with TURP, this procedure widens the urethra by making a few small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself. Although some people believe that TUIP gives the same relief as TURP with less risk of side effects such as retrograde ejaculation, its advantages and long-term side effects have not been clearly established.

Open Surgery.In the few cases when a transurethral procedure cannot be used, open surgery, which requires an external incision, may be used. Open surgery is often done when the gland is greatly enlarged, when there are complicating factors, or when the bladder has been damaged and needs to be repaired. The location of the enlargement within the gland and the patient's general health help the surgeon decide which of the three open procedures to use.

With all the open procedures, anesthesia is given and an incision is made. Once the surgeon reaches the prostate capsule, he scoops out the enlarged tissue from inside the gland.

Laser Surgery.In March 1996, FDA approved a surgical procedure that employs side-firing laser fibers and Nd: YAG lasers to vaporize obstructing prostate tissue. The doctor passes the laser fiber through the urethra into the prostate using a cystoscope and then delivers several bursts of energy lasting 30 to 60 seconds. The laser energy destroys prostate tissue and causes shrinkage. Like TURP, laser surgery requires anesthesia and a hospital stay. One advantage of laser surgery over TURP is that laser surgery causes little blood loss. Laser surgery also allows for a quicker recovery time. But laser surgery may not be effective on larger prostates. The long-term effectiveness of laser surgery is not known. (Source: excerpt from Prostate Enlargement Benign Prostatic Hyperplasia: NIDDK)

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