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Benign Prostatic Hyperplasia (BPH)

Treatments for BPH

Specific treatment for BPH will be determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or preference

Eventually, BPH symptoms usually require some kind of treatment. When the gland is just mildly enlarged, treatment may not be needed. In fact, research has shown that, in some mild cases, some of the symptoms of BPH clear up without treatment. This determination can only be made by your physician after careful evaluation of your individual condition. Regular checkups are important, however, to watch for developing problems.
Treatment for BPH may include:

  • Surgery. To remove only the enlarged tissue that is pressing against the urethra, with the rest of the inside tissue and the outside capsule left intact. Types of surgery often include the following:
    • Transurethral surgery. No external incision is needed. The surgeon reaches the prostate by inserting an instrument through the urethra.
      • Transurethral resection of the prostate (TURP). A resectoscope -- an instrument that is about 12 inches long and 1/2 inch in diameter and contains a light, valves for controlling irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels -- is inserted through the penis. 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 flushed out at the end of the operation.
      • Transurethral incision of the prostate (TUIP). A procedure that widens the urethra by making some small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself.
    • Laser surgery. Using laser instruments to cut away obstructing prostate tissue.
    • Open surgery. Surgery that requires an external incision; often performed when the gland is very enlarged, when there are complicating factors, or when the bladder has been damaged and needs to be repaired.
  • Nonsurgical treatments may include:
    • Balloon urethroplasty. A thin tube with a balloon is inserted into the opening of the penis and guided to the narrowed portion of the urethra. The balloon is inflated to widen the urethra and ease the flow of urine.
    • Transurethral microwave thermotherapy (TUMT). A device called a Prostatron uses microwaves to heat and destroy excess prostate tissue to reduce urinary frequency and urgency.
    • Medications. To shrink or at least stop the growth of the prostate without using surgery, or to make the muscles surrounding the urethra looser so the urine flows more easily.
    • Transurethral hyperthermia. An investigative procedure that uses heat, usually provided by microwaves, to shrink the prostate.
    • Prostatic stents. An investigative procedure using stents inserted through the urethra to the narrowed area that are allowed to expand, like a spring, and push back the prostatic tissue and widen the urethra.
  • Lifestyle management for BPH may include:
    • Dietary factors. Consuming foods and drinks containing soy, drinking green tea, and taking saw palmetto supplements may benefit the prostate, although this is not yet proven. Also, avoiding or decreasing the intake of alcohol, coffee, and other fluids, particularly after dinner, is often helpful. A higher risk for BPH has been found in association with a diet high in zinc, butter, and margarine, while individuals who eat lots of fruits are thought to have a lower risk for BPH.
    • Avoiding medications that worsen symptoms. Decongestants and antihistamines can slow urine flow in some men with BPH. Some antidepressants and diuretics can also aggravate symptoms of BPH. Consult your physician if you are taking any of these medications to discuss changing dosages or switching medications, if possible.
    • Kegel exercises. Repeatedly tightening and releasing the pelvic muscle, also known as Kegel exercises, is helpful in preventing urine leakage. Physicians recommend practicing this exercise while urinating in order to isolate and train the specific muscle. To perform a Kegel, contract the muscle until the flow of urine decreases or stops and then release the muscle. It is recommended that men with BPH repeat five to 15 contractions, holding each for 10 seconds, three to five times a day. Consult your physician for more information.

Locations for Benign Prostatic Hyperplasia (BPH)