TYPES OF BPH TREATMENT
Surgery is the “gold standard” treatment for BPH symptoms. In 95 percent of men, it can be accomplished in a minimally invasive way— without an incision—in a procedure called transurethral resection of the prostate (TUR). The TUR is safe, effective, and has few side effects. If your prostate is very large, however, you may need to have the kind of surgery that requires an incision. And if your prostate is very small, you may be eligible for a simpler form of the TUR, called a transurethral incision of the prostate (TUIP).
In addition to these tried-and-true forms of treatment are many new techniques for treating BPH. One of these is balloon dilation, although its popularity seems to be waning—mainly because its effccts don’t appear to be long-lasting. Other new treatments channel energy—heat, radio frequency, ultrasound, microwaves, and light— to kill the overgrowth of prostate cells surrounding the urethra. Some of these energy waves work like a shotgun, blasting holes in the prostate. Others are as sensitive as a scalpel, delicately nibbling away at BPH tissue until the urethra is free. Among these new techniques are transurethral microwave thermal therapy (TUMT), lasers, high-intensity focused ultrasound (HIFU), transurethral needle ablation (TUNA), and pyrotherapy. The goal of these techniques is to achieve the same result as with a TUR but with less anesthesia, less bleeding, and a shorter hospital stay.
Preliminary evaluation of these techniques suggests the relief of obstruction they bring may not be as pronounced as that achieved with TUR, and it’s not clear whether this relief will be as long-lasting. However, as these new techniques evolve, it’s likely that their results will improve.
An attractive option for older patients, or men in poor health who aren’t candidates for more aggressive therapy, is mechanical—special tubes called stents that hold the prostate open to relieve the squashed urethra.
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