Treatment of an enlarged prostate
If the enlarged prostate symptoms are mild, some men opt for “watchful waiting” - where no treatment is undertaken. However if symptoms deteriorate, there are two main treatment routes available.
Alpha-blockers (such as Xatral, Cardura and Doralese) relax the muscles at the neck of the bladder and in the prostate. This reduces pressure on the urethra and improves the flow of urine. They do not cure BPH but alleviate the symptoms.
5-alpha-reductade inhibitors (such as Proscar) inhibit the production of the hormone DHT, which contributes to prostate enlargement. These drugs do reverse BPH to some extent and may therefore delay the need for surgery.
Plant extracts (such as Serenoa repens) are commonly used to alleviate BPH, although formal evidence of their effectiveness is limited.
TURP (transurethral resection of the prostate) is the most common operation for BPH and is done under a general anaesthetic. A long thin camera with a light source and lens attached (known as a resectoscope) is passed into the urethra to give the surgeon a clear view of the prostate. A controlled electric current is then applied to shave off sections of the enlarged prostate.
TUIP (transurethral incision of the prostate) is a quicker operation than TURP and involves removing less tissue, under a general or spinal anaesthetic. Instead of removing a portion of the prostate, small cuts are made in the neck of the bladder and prostate to improve the flow of urine.
Open prostatectomy is only used on men whose prostate is very large. It is a major operation in which an incision is made in the lower abdomen to remove the central part of the prostate.
There are other alternative enlarged prostate treatments coming into more use today. Laser therapy (where a laser cuts away prostate tissue) and transurethral microwave thermotherapy (where heat removes prostate tissue via a probe) are becoming more common.