Prostate enlargement is often called benign prostatic hypertrophy or hyperplasia. BPH is not cancer and it does not put a patient at increased risk for prostate cancer. University Urology Associates provide some of the following minimally invasive procedures and treatments in office for patients with BPH.*

Catheterization: Placement of a catheter into the bladder will temporarily drain urine. Catheters can be placed either through the urethra or by making a small puncture into the bladder above the pubic bone (called a suprapubic tube). Catheters are most useful as a treatment of choice for temporary drainage while waiting for medication to start working, surgical schedules or clearing of infection. They also might be the most appropriate choice for a patient with multiple medical problems and a short life expectancy, where the risk and discomfort of surgery outweigh the risk of infection or cancer. Catheterization is the treatment of choice over medications or surgery for patients who have neurogenic bladder in addition to prostatic obstruction.

Medical therapy: Today's most common method for controlling moderate symptoms of BPH.

• Alpha-blockers: These drugs, originally used to treat high blood pressure, work by relaxing the smooth muscle of the prostate and bladder neck to improve urine flow and reduce bladder outlet obstruction. Although alpha-blockers may relieve the symptoms of BPH, they usually do not reduce the size of the prostate. They are usually taken orally, one or twice a day just before bedtime and they work almost immediately. Commonly prescribed alpha- blockers include: alfuzosin, terazosin, doxazosin, and tamsulosin. Side effects can include headaches, dizziness, light-headiness, fatigue and difficulty breathing
  
  
• 5-alpha-reductase inhibitors: Finasteride is an oral medication that works completely different than alpha-blockers. In some men, finasteride can relieve BPH symptoms, increase urinary flow rate and actually shrink the prostate though it must be used indefinitely to prevent recurrence of symptoms.

Transurethral electroevaporation of the prostate (TUVP): After the patient receives anesthesia, the surgeon inserts an instrument called a resectoscope through the penis into the urethra. The resectoscope contains a light, valves for controlling irrigating fluid, and a grooved rolling metal electrode. This electrode moves across the surface of the prostate and electrical current vaporizes prostate tissue. The vaporizing effect penetrates below the surface area being treated so underlying blood vessels are coagulated and sealed. Bleeding and fluid absorption are minimal and patients can usually return home without a catheter after an overnight hospital stay.

Transurethral microwave thermotherapy of the prostate (TUMT): This is an office-based procedure performed with topical and oral pain medication and does not require anesthesia. Computer-regulated microwaves are sent through a catheter to heat portions of the prostate. A cooling system works simultaneously to protect the urinary tract during the procedure. Traditionally, the best use of this procedure has been for patients who have too many medical problems for more invasive surgery or for patients who truly wish to avoid any type of anesthesia. Benefits are that there is no need for anesthesia and there is no blood loss or fluid absorption (these would be significant benefits in a person with a weak heart). Patients usually go home the same day. Many urologists have the technology available in their practice and results are pretty reliable regardless of who performs the procedure. The use of TUMT has been expanding to a broader patient population.

Transurethral radio frequency needle ablation of the prostate (TUNA): The procedure involves anesthesia and medications to make the patient sleepy. The technology involves heating of tissue using radio frequency energy transmitted by needles inserted directly into the prostate. High frequency radiowaves heat the prostate up to very high temperatures. The heated prostate tissue is destroyed and initially swells but then shrinks. Most men require a catheter for a period of time after this procedure. Advantages in the use of TUNA include the limited anesthesia requirement, the ability to perform the procedure in an office setting, and avoidance of serious complications sometimes associated with other procedures.

Interstitial laser coagulation: Anesthesia is usually required for this procedure, but patients can usually go home the same day. The technology involves placing a cystoscope (a metal tube through which the visual lens and laser can be passed). A laser is used to pierce through into the prostate and the laser energy burns the tissue. Complications and need for further treatment have been minimal so far, but more sophisticated studies must be performed.
For additional information about laser treatments for BPH and other diseases, please visit http://www.surgical.lumenis.com/optimized/urology-surgical-procedures.htm

The GreenLight PVP Laser Procedure provides a minimally invasive solution to BPH as it uses a very high-powered laser to immediately vaporize and precisely remove enlarged prostate tissue with safety and comfort.
*The GreenLight PVP Laser Procedure is performed by urologists of the University Urology Associates at a local hospital.
For more information about the GreenLight PVP Laser Procedure, please visit the LaserScope Web site at: http://www.laserscope.com/surgical/consumers/greenlight.html

*More information about minimally invasive BPH treatments can be found by visiting the American Urological Association-Education and Research Web site at:
http://www.urologyhealth.org/adult/index.cfm?cat=09&topic=104

Top of Page