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  Description Advantages Disadvantages
Watchful Waiting
  • No treatment.
  • Frequent check-ups to evaluate condition.
  • No BPH treatment side effects.
  • No relief of BPH symptoms.
Drug Therapy
  • Drugs are taken orally every day.
  • Alpha Blockers relax the muscle of the prostate and bladder neck.
  • 5-Alpha Reductase Inhibitors prevent conversion of testosterone to DHT.
  • Hospitalization not required.
  • Non-invasive.
  • Requries lifelong use of medication.
  • Effectiveness may decrease over time, potentially resulting in the need for surgery.
  • Side effects: reduced libido, impotence, breast tenderness and enlargement and reduced sperm count.

Prostatic Stent
  • A tiny, springlike device is inserted into the urethra to increase flow.
  • For patients with significant medical problems that prohibit medication or surgery.
  • Urinary incontinence, dislodgement of stent position, stone formation on the stent with blockage and difficulty removing the stent.

Photo-Selective Vaporization of the Prostate:
GreenLight PVP


  • A minimally invasive procedure that uses a special high-energy laser to vaporize excess prostate tissue and seal the treated area.
  • Immediate symptom relief and dramatic flow rate improvements - the long-lasting results of more aggressive surgery.
  • Procedure is extremely fast. Takes between 10 and 30 minutes to perform.
  • Many patients do not require a catheter.
  • Safe, minimally invasive, virtually blood-free, little or no side-effects.
  • No rectal thermal monitoring device needed.
  • Preserves sexual functions.
  • Patients are advised to avoid strenuous exercise for two weeks following the procedure.
  • Requires insertion of an endoscope into the urethra (though various anesthetic options can be used, from local to general, to insure patient's comfort).

Microwave
Thermotherapy:
Prostatron


  • A non-surgical treatment that sends computer-regulated microwaves through a catheter to heat selected portions of the prostate.
  • The heat destroys enlarged prostate tissue.
  • Chilled water is circulated inside the catheter to protect the urethra.
  • Anesthesia-free, the procedure takes about an hour and is performed on an outpatient basis.
  • Clinical outcomes have virtually matched conventional surgical interventions and surpassed medical management.
  • Does not cause incontinence or impotence.
  • Long-lasting results.
  • Most patients resume normal activity immediately after treatment.
  • Possible complications include urinary retention and mild-to-moderate frequency, urgency, and straining.
  • Most complications resolve without intervention during the healing period.
Transurethal Surgery
  • Surgeon inserts instrument through urethra in the penis to remove excess prostate tissue one piece at a time using electricity.
  • Inpatient procedure lasting 30 to 60 minutes.
  • Traditional surgical procedure for BPH.
  • Immediate symptom relief.
  • Curative.
  • Increased risk of impotence and retrograde ejaculation.
  • Up to 30% of patients experience problems with sexual function after procedure.
  • Hospital stay of 1 – 3 days typically required.
Open Surgery
  • Patient is anesthetized, surgeon makes an incision in the back or perineum and removes the prostate.
  • Typically reserved for when prostate is very large or when transurethral procedures are not possible.
  • Curative.
  • Potential complications include incontinence and impotence.
  • Urge continence and involuntary passing of urine while asleep may occur.
  • Erectile and ejaculatory dysfunction may occur.