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All about benign prostatic hyperplasia (BPH) causes of benign prostatic hyperplasia benign prostatic hyperplasia symptoms diagnosis of benign prostate hyperplasia benign prostatic hyperplasia risk factors treatment of benign prostate hyperplasia lifestyle for benign prostate hyperplasia benign prostatic hyperplasia medications BPH alternative medicines BPH surgery BPH gentle surgical treatments when to treat benign prostatic hyperplasia BPH surgery and medication

How to decide between surgery and medication for benign prostatic hyperplasia (BPH)?

If a man opts for treatment, there are a number of choices. Most experts recommend a staged approach as follows:
  • Medications are the best choice for patients with mild symptoms who decide to have their condition treated. Such men have the same risks for surgical complications as patients with more severe symptoms, but they usually experience only a slight benefit. The major drug groups are alpha-blockers (which are usually the better choice) and anti-androgens (nearly always finasteride).
  • Men with moderate to severe symptoms still have good choices among drugs and surgeries. If a man chooses surgery, there are many choices. Transurethral resection of the prostate (TURP) is the standard procedure, but less invasive procedures, particularly those using heat to destroy prostate tissue, are gaining prominence.

  • Drugs versus Surgery. Recent developments in drug therapy have reduced the number of surgical procedures needed and delayed their use. In men with severe symptoms, however, surgery is often needed eventually. For example, in men with small prostates and severe symptoms, alpha-blocking agents work more quickly than microwave treatment, a minimally invasive procedure that uses heat to destroy prostate tissue. The microwave procedure, however, has a greater rate of success.

    The most common reason for choosing surgery is obstruction of the bladder outlet, which causes urinary retention. Surgery is also typically a reasonable option when benign prostatic hyperplasia is clearly related to one or more of the following conditions:

  • Recurrent urinary tract infection.
  • Hematuria (blood in the urine). Studies have suggested that left untreated, two-thirds of patients continue to bleed and one third require surgery. The drug finasteride may help some men with this condition and should probably be tried before surgery.
  • Bladder stones.
  • Kidney problems.
  • Some experts believe that surgery might benefit patients for whom an early diagnosis of prostate cancer is important. Unsuspected prostate cancer is detected during surgery in about 15% of cases.
  • The greatest improvements resulting from surgery are usually increased urinary flow and reduced urine retention. In one study, men who chose surgery reported more worry and depression before the procedure, but afterward they had less depression and anxiety than those who had chosen medication. In many cases, the benefits of surgery are not permanent, however.

    More information on benign prostatic hyperplasia (BPH)

    What is benign prostatic hyperplasia (BPH)? - Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is a noncancerous enlargement of the prostate gland that occurs in almost all men as they age.
    What causes benign prostatic hyperplasia (BPH)?
    - Benign prostatic hyperplasia (BPH) is probably a normal part of the aging process in men, caused by changes in hormone balance and cell-growth factors.
    What are the symptoms of benign prostatic hyperplasia? - Initial symptoms of BPH include difficulty starting to urinate and a feeling of incomplete urination. Urinary tract infections cause burning or pain during urination, and possibly fever.
    How does the doctor diagnose benign prostate hyperplasia? - Patients will be asked about their symptoms and may also be asked to fill out a symptom questionnaire to let the doctor know the nature of the symptoms and how troublesome they are.
    Who is associated with benign prostatic hyperplasia? - Age is the major risk factor. A family history of BPH appears to increase a man's chance of developing the condition. Diabetes, in any case, worsens urinary tract symptoms in men with BPH.
    How is benign prostate hyperplasia treated? - Treatment for benign prostatic hyperplasia (BPH) focuses on reducing your symptoms. Treatment is based on how severe your symptoms are, how much they bother you, and whether complications are present.
    What're lifestyle measures for managing benign prostate hyperplasia? - Certain lifestyle changes can help relieve symptoms and are particularly important for men who choose to avoid surgery or drug therapy. Men with BPH should avoid, if possible, the many medications for colds and allergy that contain decongestants, such as pseudoephedrine (Sudafed).
    What kinds of medicines are used for benign prostatic hyperplasia (BPH) treatment? - Alpha-blockers relax smooth muscles, especially in the urinary tract and prostate. They include terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), and alfuzosin (Xatral). 5-alpha-reductate inhibitors are a group of anti-androgens. In other words, they block male hormones, particularly dihydrotestosterone.
    What are alternative medicines for benign prostatic hyperplasia (BPH) treatment? - Some herbal medicines may be helpful, but no one should take any herbal medication or attempt to treat BPH without first consulting a physician.
    What kind of surgery is available for benign prostatic hyperplasia (BPH) treatment? - An operation on the prostate will involve the removal of parts of the enlarged tissue. The most effective surgical procedures, transurethral resection of the prostate (TURP) and open prostatectomy, are also the most invasive.
    Are there other more gentle surgical treatments for benign prostatic hyperplasia (BPH)? - Microwave thermotherapy reduces the size of the prostate by causing cells in the centre of the prostate to die. Another endoscopic treatment, in which part of the prostate tissue is removed with laser energy.
    How to choose between treatment and watchful waiting for benign prostatic hyperplasia (BPH)? - The choice between watchful waiting and treatment usually depends on a number of factors, such as urine flow rates, prostate size, and PSA levels.
    How to decide between surgery and medication for benign prostatic hyperplasia (BPH)? - If a man opts for treatment, there are a number of choices. Medications are the best choice for patients with mild symptoms who decide to have their condition treated. Men with moderate to severe symptoms still have good choices among drugs and surgeries.
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