Urology
Urological Conditions
Benign Prostatic Hyperplasis (BPH)
Non-Surgical Treatments
Non-surgical treatments shrink the prostate by using
heat to destroy excess tissue. Treatment methods differ in their
heat sources (which include lasers, microwave energy, radio waves
and electrical current) and possible side effects, but most require
only a few days’ recovery time. Treatment methods include:
Laser treatments. PVP (photoselective vaporization
of the prostate) uses an endoscope to direct a high-energy
laser into the prostate.
The laser
evaporates the prostate tissue, clearing up any obstruction
with minimal blood loss. Depending on the size of the enlarged
prostate gland, the procedure lasts between 20 to 50 minutes,
and can be done under local anesthetic on an outpatient basis.
You may need to use a catheter after the procedure, usually
for less than 24 hours. The procedure usually offers immediate,
long-lasting results with minimal side effects. These side
effects can include pain, blood in the urine, and swelling,
but they normally disappear during the recovery period.
Strong Health urologists have been working to help make this procedure a standard treatment for the thousands of men with BPH. Among other things, they have hosted seminars to help community urologists learn how to perform the procedure.
Interstitial Laser Coagulation. This procedure uses a cystoscope to direct laser energy into the prostate. Heat from the laser coagulates and destroys the obstructing prostate tissue. This is an outpatient procedure; you’ll be given local anesthesia and can return home after the 30 to 60 minute treatment plus some recovery time. A common side effect is blood in the urine and you may need to use a catheter for a few weeks after the procedure. Rare side effects are impotence, retrograde ejaculation and incontinence. The treatment seems to work best for men with large prostates.
Other laser treatment methods include transurethral evaporation of the prostate (TUEP), noncontact visual laser ablation (VLAP), and Holmium laser enucleation of the prostate (HoLEP). Ask your urologist for details about these treatment options.
Microwave treatments. TUMT (transurethral microwave therapy) uses a urinary catheter through which a tiny microwave antenna is inserted to direct microwave energy into the prostate to heat and destroy the excess tissue. During the procedure, cool water circulates around the antenna to protect the urinary tract from the heat, minimize discomfort and reduce risk of serious side effects. You may feel heat in the prostate or bladder, as well as a strong desire to urinate, and/or bladder spasms. TUMT is normally an outpatient procedure; you may be given local anesthesia, and/or topical or oral pain medication and can return home after the treatment and recovery time. You may need to wear a urinary catheter for a few days after the treatment. Side effects can include frequent urination, urgent need to urinate (urgency), inflammation and swelling of the urethra and soreness in the lower abdomen. TUMT seems to be less effective for men with very large or growing prostates.
Radio wave treatments. TUNA (transurethral needle ablation) uses a special catheter containing tiny needles that send radio waves into the prostate, to heat and destroy the excess tissue. TUNA is normally an outpatient procedure that takes about an hour. You may be given some anesthesia but you can return home after the treatment and recovery time. You may need to wear a urinary catheter for a few days after the treatment. Possible side effects can include blood in the urine, discomfort or pain when urinating, urinary retention, and sexual dysfunction. Normally these side effects resolve (disappear) during the healing period. TUNA seems to be less effective for men with very large or growing prostates.
Electrical treatments. TUVP (transurethral electrovaporization of the prostate) uses a resectoscope (a tiny metal instrument inserted through the penis into the urethra) to direct a high-frequency electrical current into the prostate to vaporize the excess tissue. You will be given anesthesia and will need to stay in the hospital at least overnight. But you can usually return home without a catheter and should see an improvement in your symptoms very quickly.
Water treatments. WIT (water-induced thermotherapy) uses a catheter with an inflatable balloon that has hot water running through it. The heat destroys the excess prostate tissue. WIT is an outpatient procedure that takes about 45 minutes. You may be given local anesthesia and you can return home after the treatment and recovery time.
More Information
For more information on these and other non-surgical treatments for BPH, please visit the American Urological Association.