Treatment Options for BPH

Treatment will be determined by you and your physician, based on:

  • Your age, overall health, and medical history.
  • Potential side effects of specific medication, procedures, and therapies.
  • Expectations for the course of the disease.
  • Your opinion or preference.

When the gland is just mildly enlarged, treatment may not be needed, as research has shown that symptoms can sometimes on their own clear up. Eventually, BPH symptoms usually require some kind of treatment. This determination can only be made by your physician after careful evaluation of your individual condition. Regular checkups are important to watch for developing problems.

Dr. Scott Kahn sees patients in Poughkeepsie, Fishkill and Rhinebeck. He specializes in the treatment of BPH.

Treatment for BPH may include...

Medications
There are two standard classes of medications available to treat BPH.

Proscar (finasteride), Avodart (Dutasteride)
These medications are designed to shrink or stop the growth of the prostate without using surgery. These medications take about 3 to 6 months to begin to see signs of improvement in your urinary symptoms.

Flomax (Tamsulosin), Uroxatral (Alfuzosin) and Rapaflo (Silodosin)
They are called alpha blockers. These medications work by reducing the muscular tension in the prostate. Usually you can see positive results within a few days.

Minimally Invasive Surgery
Surgery used to remove the enlarged tissue that is pressing against the urethra, while leaving the rest of the inside tissue and the capsule left intact. Types of minimally invasive surgery often include the following:

Transurethral Surgery
No external incision is needed. The surgeon reaches the prostate by inserting an instrument through the urethra.

Transurethral Resection of the Prostate (TURP)
A special instrument called a resectoscope - containing a light, valves for controlling irrigating fluid, and an electrical loop that cuts tissue and seals blood vessels - is inserted through the urethra. The surgeon uses the resectoscpe's wire loop to remove the obstructing prostrate tissue one piece at a time. The pieces of tissue are carried by the fluid irrigation into the bladder and flushed out at the end of the operation. This procedure is performed under anesthesia in the hospital and usually requires an overnight.

Transurethral Incision of the Prostate (TUIP)
A procedure that widens the urethra by making incisions with an electrical current in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself. This procedure is performed under anesthesia in the hospital and may require an overnight stay in the hospital.

Transurethral Laser Prostatectomy
Similar to the TURP; however, a laser fiber is used to vaporize obstructing prostate tissue. This procedure can be done in the office with IV anesthesia. Home the same day.

Open Surgery
This is surgery that requires an external incision; often done when the gland is very enlarged, when there are complicating factors (large bladder stones), or when the bladder has been damaged and needs to be repaired.

Non-surgical Treatment

Balloon Urethroplasty
A thin tube with a balloon is inserted into the opening of the penis and guided into the prostatic urethra, where the balloon is inflated to widen the prostate channel.

Transurethral Needle Ablation of the Prostate (TUNA)
A device that is inserted into urethra and positioned at the level of the prostate. Two needles are then deployed into the prostate. A radio-frequency current is passed through the needles into the prostate to heat and destroy only the enlarged portion of the prostate. Performed under IV anesthesia in the office and patient goes home the same day. This procedure is considered the least invasive of all the procedures. At Premier Medical Group Urology Division, this procedure is performed in the Poughkeepsie surgical suite.

Transurethral Microwave Thermotherapy (TUMT)
A device called a Prostatron uses microwaves to heat and destroy excess prostate tissue surrounding the urethra.

Prostatic Stents
A procedure using stents, which are allowed to expand like a spring and push back the prostatic tissue and widen the urethra. This proceedure is only used in very special situations which your urologist can review with you.

Life-style management for BPH may include:

Dietary Factors
Increasing your intake of soy, drinking green tea, and taking saw palmetto supplements may benefit the prostate, although this is not proven. Also, avoiding or decreasing your intake of alcohol, coffee, tea and other fluids, particularly after dinner, is often helpful. A higher risk for BPH has been found in association with diets high in butter, and margarine, while individuals who eat lots of fruits are thought to have a lower risk for BPH.

Avoiding Medications That Worsen Symptoms
Decongestants and antihistamines can slow urine flow in some men with BPH. Some antidepressants and diuretics can also aggravate symptoms of BPH. Consult your physician if you are taking any of these medications to discuss changing dosages or switching medications, if possible.

Kegel Exercises
Repeatedly tightening and releasing the pelvic muscles, also known as Kegel exercises, is helpful in preventing urine leakage. Physicians recommend practicing this exercise while urinating in order to isolate the specific muscle that controls your urine: contract the muscle until the flow of urine decreases or stops, and then release the muscle. It is recommended that men with BPH repeat five to 15 contractions, holding each for 10 seconds, three to five times a day. Consult your physician for more information.

Brochures with valuable information are available in our Poughkeepsie, Fishkill, Kingston and Rhinebeck offices.