The enlarging of the prostate gland occurs naturally as men age. Unfortunately, this process can press on the urethra and result in nuisance side effects including urination and bladder problems. The good news is that an enlarged prostate is benign (not cancerous) nor will it increase your risk of prostate cancer; for these reasons it is often referred to as benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy.
The exact cause of BPH is unknown; however, a common hypothesis points to changes in the balance of the sex hormones during the aging process. The testicles may also play an important role in prostate growth: for example, men who have had their testicles removed (i.e. as a result of testicular cancer) do not develop BPH. Furthermore, men who have their testicles removed after having developed BPH will experience a decrease in prostate size.
There are many treatment options available for BPH: medications, minimally-invasive procedures and surgery. What treatment option is best for you depends on your overall treatment goals, the size of your prostate, your symptoms, age and overall health. Make sure you speak with your doctor about the different treatment options; your doctor may recommend treatments based on your symptoms and treatment goals.
Prescription drugs are typically the first line of treatment for BPH. Alpha blockers are typically associated with high blood pressure, but in the case of BPH, act by relaxing the muscles in both the bladder neck and prostate, resulting in effortless urination. The effects of alpha blockers are typically seen very quickly (in about a day or two). 5 alpha reductase inhibitors reduce the size of the prostate, thus reducing the pressure on the urethra. Often, improvements are not seen for a couple of weeks or even months. Common side effects include decreased sex drive and impotence. Combination therapy of alpha blockers and 5 alpha reductase inhibitors can be more effective than either drug alone. Antibiotics may also be prescribed to treat prostatitis (prostate inflammation) which can accompany BPH.
Minimally Invasive Procedures
GreenLight Laser uses a high-powered laser combined with fiber optics to vaporize the overgrowth of prostate cells quickly and accurately. The heat of the laser also cauterizes blood vessels, resulting in minimal bleeding. It is an out-patient procedure that involves catheterization for about two days. Stents can be placed in the urethra to help keep it open and allow urine to flow easier. These stents must be replaced every four to six weeks, and as such, are not considered a long term treatment option.
If medications are not effective, or if your prostate is too large, surgical intervention may be necessary. Transurethral resection of the prostate (TURP) involves the removal of portions of prostate which block urine flow. Hospital stay is typically one day with a two-day catheterization. Prostatectomy is the complete removal of the prostate gland. It is more invasive than TURP or GreenLight Laser, usually has a higher risk of complications and side effects and requires a longer catheterization. For these reasons, prostatectomies are typically reserved for those with unbearable BPH symptoms and those with extremely large prostates.