What is Benign Prostatic Hyperplasia (BPH) Management?
BPH management is a set of steps taken to treat Benign Hyperplastic Hyperplasia.
BPH is a common disorder among aging men, where a continuous growth of the prostate gland results in hyperplasia and a number of symptoms related to urination.
Types of BPH Management?
The management and treatment options for BPH consists of various approaches. This includes both:
- Medical Interventions, and
- Surgical Resections of the Prostate Gland itself.
The approach in BPH management of any case is determined by your doctor depending on the patient’s
- the size and progression of the Prostate enlargement,
- lab results,
- the overall health of the patient
- the severity of the symptoms
- presence of complications due to the hyperplasia.
Why is the BPH Management Required?
BPH can result in distress, as urination is one of the fundamental functions of life.
The symptoms can range from mildly annoying to severe enough that the patient would be afraid to drink fluids, in order to avoid urination and associated discomfort.
Who can Benefit from BPH Management?
Every case of BPH can benefit from management, however, it can be deferred in cases with no symptoms or very minor symptoms.
Medications for BPH Treatment
Medicine works best in cases with mild to moderate symptoms and includes
- Alpha blockers – They act by relaxing the neck of the bladder and surrounding tissues, making it easier to urinate.
- 5 Alpha-Reductase Inhibitors – This group of drugs results in size reduction of the prostate gland, again, making urination easier
- Combination – A combination approach can also be given in certain cases. These work by relaxing bladder muscles and shrinking the prostate gland, respectively.
Advanced BPH Treatments
In more advanced cases of Benign Hyperplastic Hyperplasia, the prostate gland is treated with surgery with a wide variety of procedures,
- UroLift® - involves sutures being placed into the prostate that effectively squeezes the urethra open
- Trans-urethral Resection Of The Prostate – TURP. A telescope is inserted via the urethra and the enraged part of the prostate gland is removed
- Trans-urethral Incision Of The Prostate – TUIP (or Bladder Neck Incision BNI) - for this procedure incisions are only made in the prostate gland to make urination easier
- Trans-urethral microwave therapy – TUMT - where microwave heat is used to shrink the prostate gland to achieve relief of symptoms, it has a very specific case use and often requires some follow up sessions.
- Rezum – Using water vapour (steam) which is injected into the prostate causing the enlarged parts of the prostate to die and be reabsorbed by the body.
- Laser Therapy - Using a laser fibre to perform the TURP.
- Embolization – where the blood supply to the prostate is cut by doing an angiogram of the prostate arteries resulting in shrinkage in size of the prostate to allow easier passing of urine.
- Robot-Assisted Prostatectomy - uses a robotic approach, to remove the enlarged part of the prostate gland.
- Open Prostatectomy – open approach via the perineal or pubic to access and remove the enlarged part of the prostate gland.
In all approaches, a prostate gland MRI or biopsy may also be conducted to rule out prostate cancer, as the symptoms can overlap.
What should be expected after BPH Management?
There should be a noticeable improvement in urination and increased comfort level, improving the patient’s quality of life. Improvement can take time.