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Hormone-Therapy-for-BPH

There are many treatment options for BPH, depending on the severity of symptoms.

Affecting approximately 90 percent of men ranging in age from their mid-forties to eighties, benign prostatic hyperplasia (BPH) can lead to persistent and disruptive symptoms. Some men with a larger prostate may have minor symptoms, while others with a slightly enlarged gland might have more noticeable issues.

  • Also known as an enlarged prostate gland, BPH may require little or no intervention if symptoms are mild.
  • If urinary tract, bladder, or kidney problems are experienced, there are several treatments a urologist may recommend.

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Periodic Observation

If BPH symptoms are mild and not significantly disrupting urination habits, treatment may involve regular visits to a urologist for periodic observation to track any changes in the growth of the prostate gland and the progression of symptoms. Outpatient testing may include urine flow tests and a visual inspection of the bladder and other parts of the urinary system with a flexible cystoscope.

Treating BPH with Medication

Barring serious symptoms, the first attempt at treating BPH other than watchful waiting is usually medication. Alpha blockers such as Flomax and Uroxatral relax muscle fibers in the prostate and bladder neck muscles. Proscar and Avodart are some of the specific types of 5-alpha reductase inhibitors that may be prescribed to inhibit hormone growth and shrink the enlarged prostate. Some patients benefit from a combination of both types of medication. There's also research suggesting the erectile dysfunction drug tadalafil could help manage BPH symptoms.

Surgical-Treatment-of-BPH
Laser-Therapy-Treatment-for-BPH

Minimally Invasive Procedures for BPH

When BPH symptoms range from moderate to severe and medications aren't effective, minimally invasive procedures may provide relief. Some surgeries of this nature involve removal of the outer part of the prostate and cuts within this gland, while others use microwaves and radio waves to remove tissues.

Laser Therapy for Prostate Enlargement

Procedures that use high-energy laser beams are generally considered to have fewer risks than other types of surgery to remove prostate overgrowth. Ablative procedures use laser energy to destroy tissues and increase urine flow. Enucleative procedures often prevent regrowth of vaporized tissues.

Adjustments to Lifestyle Habits

Another non-surgical treatment option for men with mild BPH is changes to lifestyle habits. What's specifically recommended is usually based on what's most comfortable for patients. For instance, some men may prefer to start with mild changes such as drinking more water, limiting liquids before bed, and avoiding excessively spicy, sugary, or processed foods. Other recommendations may include:

  • Eating more nutrient-rich vegetables and fruits
  • Pelvic floor and/or kegel exercises
  • Reducing alcohol consumption
  • Maintaining or reaching a healthy weight range
  • Lowering the dosage of certain medications

Frequent urination is the symptom most men first notice when their prostate starts to press on the bladder. Since this can be a sign of many different urinary system problems, a urologist typically performs several tests to make a positive diagnosis so an appropriate treatment can be suggested. Such testing typically includes a digital rectal exam, urine and blood tests, and a urine flow test. You may also be asked to keep a voiding diary for a day or two to track urination patterns.

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faculty_gelman
Joel Gelman, M.D.
Male Urology
HS Clinical Professor-VCF
faculty_yafi
Faysal A. Yafi, M.D., F.R.C.S.C.
Male Urology
HS Assistant Clinical Professor, Medical Director Men’s Health Program

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