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Nonsurgical Treatment Alternatives
"Watchful Waiting." If your symptoms are
not interfering with your quality of life, or causing you too much inconvenience,
you may decide to do nothing. Your symptoms will not go away, but you
might be able to delay treatment for a while. Watchful waiting should
not be confused with benign neglect. Your condition will still need to
be monitored by a physician. Medications Medications available for BPH relieve your actual symptoms, however, they do not cure or reverse the development of BPH. There are four medications commonly prescribed to relieve common symptoms of an enlarged prostate. These are:
Drug therapy involves a life-long commitment to taking medication every day, for the remainder of your life. Many people find this difficult to follow over extended periods, particularly when they have multiple other medications to take as well. Medications can be quite costly, and are often not covered by insurance. Some men experience side effects from the drugs, such as side effects, like dizziness, fainting, impotence, or headaches. Others find the drug appears to become less effective over time, causing their symptoms to return. If further treatment is necessary, understanding both your own body and the alternatives is key. Your physician can offer you guidance, based upon his clinical findings of your condition as well as his experience. Cooled Thermotherapy Cooled ThermoTherapy is designed to solve the problems of an enlarged prostate without the need for drugs, needles, anesthesia or a hospital stay. Cooled ThermoTherapy is a single, non-surgical procedure that can be performed in the comfort of your urologist's office or in a hospital outpatient setting. The treatment uses a specially-designed catheter that directs high energy heat deep into the prostate to safely destroy the enlarged tissue and reduce the pressure being placed on the urethra. TUMT (Thermotherapy) Transurethral Microwave Thermotherapy (TUMT) is another relatively new procedure for the treatment of BPH being used today. This is performed on an outpatient basis, using microwave energy to heat and destroy the prostatic tissue. Rectal and urethral probes ensure that untargeted tissue will not heat above safe levels. It can be confusing, trying to decide which is the best treatment for you. It's best to talk over options with your doctor. Write down any questions you may have regarding the advantages and disadvantages of the different treatment methods. Surgical Treatment Alternatives Surgery used to be the only option for the treatment of BPH. The management of BPH is changing rapidly, as new, minimally-invasive procedures become available. TURP Transurethral Resection of the Prostate (TURP) has been recognized as the "gold standard" of surgical treatment options for therapy. Transurethral resection of the prostate (TURP) requires spinal or general anesthesia and hospitalization for several days. |
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A rigid cystoscope is inserted into the penis and bladder, which allows the urologist to visualize the obstructing portions of the prostate, and to surgically remove them. While TURP is widely used and well established, there are several well known risks or complications associated with the procedure. These include impotency, incontinence, retrograde ejaculation, hemorrhage, and others. Transurethral resection of the prostate (TURP) was first introduced in the 1930's. It did not become widely used until the after 1968, when great improvements in instrumentation became available. Today, TURP is still the most common method for treatment of BPH, however, newer minimally-invasive technologies are becoming increasingly accepted and popular. |
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Interstitial Laser Coagulation of the Prostate Like TURP, a rigid
metal cystoscope is inserted into the penis and bladder, which allows
the urologist to directly visualize the prostate. Rather than cutting
tissue away with a loop, as is done with TURP, a laser fiber is inserted
into several places within the prostate gland. The laser destroys the
prostatic tissue. This procedure is done in the operating room, under
general or spinal anesthesia. Destroyed tissue is absorbed by the body
or is voided out with your urine over a period of weeks. Suprapubic (Open) Prostatectomy If the prostate is very enlarged, it cannot be safely removed through the urethra. In this situation, an incision is made in the lower abdomen while the patient is under general or spinal anesthesia. Once the incision has been made, the bladder is opened and the prostate gland is removed, leaving the prostatic capsule intact. Urethral and suprapubic (abdominal) catheters are left in place to permit urinary drainage and to control bleeding. The catheters are usually removed a few days after surgery. |
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