For most patients, BPH (benign prostatic hyperplasia) is curable. Some people see a significant reduction in symptoms with medication alone. If medications don't work or the prostate is too large, surgery may be necessary to provide relief. If your symptoms are tolerable, you may decide to postpone treatment and simply control your symptoms.
In some men, symptoms may be relieved without treatment. Transurethral microwave thermotherapy (TUMT) is a procedure where a special electrode is inserted through the urethra into the prostate area. The microwave energy from the electrode destroys the inner part of the enlarged prostate, shrinking it and facilitating the flow of urine. The TUMT may only partially relieve your symptoms and it may take some time before you notice the results.
Transurethral resection of the prostate (TURP) is usually used only on small prostates under special circumstances because it may need to be retreated. Special labels are used to compress the sides of the prostate to increase urine flow. The procedure may be recommended if you have symptoms in your lower urinary tract. Prostatic urethral lift (PUL) may also be offered to some men concerned about the impact of treatment on erectile dysfunction and ejaculatory problems, since the effect on ejaculation and sexual function is much lower with PUL than with TURP. For a long time, treatment for BPH has consisted of medications and procedures, such as lasers or an electrical circuit, that burn the prostate from the inside out.
But now, a relatively new convection water therapy treatment uses steam to make the prostate smaller. Mayo Clinic specialists are trained in a wide range of cutting-edge technologies to treat prostate enlargement. You have access to the latest non-invasive laser treatments, including HoLEP and PVP lasers. The Mayo Clinic specialist will explain the variety of treatments available to you and help you choose the best approach based on your symptoms. The Food and Drug Administration has not approved any herbal medications for the treatment of an enlarged prostate.
Studies on herbal therapies as a treatment for prostate enlargement have had mixed results. One study found that saw palmetto extract was as effective as finasteride in relieving symptoms of BPH, although prostate volumes were not reduced. However, a subsequent placebo-controlled trial found no evidence that saw palmetto is better than a placebo. Other herbal treatments, such as beta-sitosterol extracts, pygeum and rye grass, have been suggested to be useful in reducing symptoms of prostate enlargement. However, the long-term safety and effectiveness of these treatments have not been demonstrated.
If the symptoms of an enlarged prostate are mild and not bothersome, treatment may not be needed. A third of men with mild BPH find that their symptoms go away without treatment. They might just watch and wait. The prognosis for people with benign prostatic hyperplasia of the prostate is very good. There's no cure for BPH, but treatments can help ease symptoms. Mild symptoms may not need treatment.
Medications, surgery, and minimally invasive treatments can treat the most serious cases. Alpha-blockers are usually the first type of medication offered to you, unless your prostate is very large. Your symptoms may start to improve within a few hours or days, but you may need to take alpha-blockers for a few weeks before they take full effect. Most men who take alpha-blockers find that their symptoms improve within a few weeks of treatment. If your symptoms haven't improved after about four to six weeks, your doctor may suggest that you try a higher dose or a different treatment.
For most men, alpha blockers continue to work for several years. It is used to treat men with moderate to severe urinary symptoms who have moderate prostate enlargement. If the symptoms of prostate enlargement are disturbing or do not respond to conservative approaches, surgery may be recommended. In this experimental procedure, the blood supply to or from the prostate is selectively blocked, causing the prostate to decrease in size. After that, the doctor may recommend additional tests to help confirm an enlarged prostate and rule out other conditions.
While it's difficult to completely reverse an enlarged prostate, there are several treatments that can alleviate symptoms, reduce the size of the prostate, and help restore normal urine flow. This surgery may be an option if you have a small or moderately enlarged prostate, especially if you have health problems that make other surgeries too risky. Be sure to tell your doctor about any medications or herbal remedies you are already using, in case they interfere with medications for prostate enlargement. If your enlarged prostate isn't causing problems, you may decide to wait and see if your symptoms get worse before getting treatment. The urethra, or the tube that carries urine from the bladder to the penis, is surrounded by the prostate and is often squeezed and compressed as a result of an enlarged prostate. Toby Kohler, a Mayo Clinic urologist, says that an enlarged prostate causes the urethra to narrow, causing a variety of problems with urination.
The symptoms and need for treatment vary depending on each man's enlarged prostate.