Benign Prostatic Hyperplasia

Management and Treatment

Can benign prostatic hyperplasia be cured?

There isn’t a cure for BPH. However, treatment options are available to help alleviate your symptoms.

How is benign prostatic hyperplasia treated?

If you have mild symptoms, you may not require any treatment. Your healthcare provider may recommend a “watchful waiting” approach in which you schedule regular appointments to ensure your BPH doesn’t get any worse.

Treatment options include:

Medications

The most commonly prescribed medications relax the muscle in your prostate, which reduces tension on your urethra. Examples include:

• Tamsulosin (Flomax®).
• Terazosin (Hytrin®).
• Doxazosin (Cardura®).
• Alfuzosin (Uroxatral®).
• Silodosin (Rapaflo®).

Some medications decrease the production of the hormone DHT, which can slow the growth of your prostate gland. These medications are most beneficial to people with larger prostates. Examples include:

• Finasteride (Proscar®).
• Dutasteride (Avodart®).

Your healthcare provider may prescribe combined medications that help treat your symptoms as well as improve your urine flow. One example is dutasteride and tamsulosin (Jalyn®).

After you start a medication, it may take between one and eight weeks for your symptoms to improve.

Surgery

Several different types of surgery can remove prostate tissue that blocks your urethra. These include:

• Transurethral resection of the prostate (TURP). Your urologist inserts a special instrument (resectoscope) through your urethra that allows them to see and remove prostate tissue.
• Transurethral incision of the prostate (TUIP). Your urologist makes two small incisions in your prostate and where your urethra and bladder join (bladder neck) to widen your urethra and improve urine flow.
• Transurethral electrovaporization. Your urologist uses an electrode to heat your prostate tissue. This turns the tissue cells in the enlarged areas of your prostate into steam.
• GreenLight™ laser. Your urologist uses a special laser to evaporate your enlarged prostate tissue.

After a surgical procedure, you should be able to resume normal activities within a few days or a week.

Minimally invasive treatments

New BPH treatments are less invasive and damaging to healthy tissue than surgery. In general, most of these treatments are outpatient procedures, which means you can go home the same day as the procedure. They’re also cheaper, have fewer side effects and allow for a faster recovery. However, because these techniques are new, there isn’t much information about their long-term effects or complications.

Examples of minimally invasive treatments include:

• Prostatic urethral lift. This procedure separates your enlarged prostate lobes to make your urethra wider, making it easier to pee. Your urologist inserts a special instrument (UroLift®) into your urethra and up to your prostate. When the UroLift reaches the side wall of your prostate, it ejects small implants that pull your prostate lobes apart and open your urethra. Your urologist may place two to six implants, depending on the size of your prostate.
• Water vapor therapy. Your urologist inserts an instrument into your urethra and moves it to your prostate. Your urologist then ejects a needle into your prostate. The needle emits steam vapor, which turns into water. The water’s thermal energy destroys your prostate cells. Your body reabsorbs the dead cells, and your prostate shrinks. Another name for this procedure is the Rezūm™ System.

The most common side effects of these treatments include peeing more than normal and discomfort or irritation while your prostate heals.

After a minimally invasive procedure, you should be able to return to your normal activities in a few days. You should see improvements in your symptoms within three to six weeks.

What is the best treatment for benign prostatic hyperplasia?

TURP is the most effective treatment for most cases of BPH.

However, in adults 65 and older, medications and minimally invasive treatments are preferable. Older patients may have more complications and a longer recovery time after surgery.

What can/can’t I eat/drink if I have benign prostatic hyperplasia?

Fruits, vegetables and healthy fats may benefit your prostate health. Consider following the Mediterranean diet or incorporating more of the following in your meals:

• Berries.
• Broccoli.
• Citrus.
• Nuts.
• Tomatoes.
• Turmeric.

A poor diet may worsen your BPH. If you have BPH, it’s a good idea to avoid processed foods, sugars and large amounts of carbohydrates as well as:

• Alcohol.
• Caffeine.
• Dairy.
• Red meat.
• Sodium (salt).

Can an enlarged prostate go back to normal?

In some people with mild BPH, their symptoms went away without treatment. If your symptoms don’t go away during a watchful waiting approach, you and your healthcare provider should start discussing treatment options.