|
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.
|