Big results with low side effects? How minimal can BPH treatments get?

August 25, 2020

BPH, or enlarged prostate is a common condition that can affect men as early as age 30. As the prostate is an organ specific to the male reproductive anatomy, it is also considered “man’s lifelong friend or enemy” that is responsible for symptoms like frequency, urgency, nighttime urination, weak stream, or overactive bladder symptoms. Unless it is treated or removed, an enlarged prostate will sometimes progress to the point where it can cause urinary blockage, bladder dysfunction, or, in worst case scenarios, bladder and/or kidney failure.

The good news with BPH is that there are numerous treatments that are available to keep the prostate at a healthy size. And as technology advances, the treatments become more minimally invasive. A few examples of minimally invasive BPH (enlarged prostate) treatments include:

UroLift ™, or Prostatic Urethral Lift – For patients with mild to moderate prostate enlargement or certain prostate shapes, the Urolift procedure aims to improve urinary issues related to BPH by applying clips that lift and staple prostate tissue in a manner to create an open channel. This often provides immediate, rapid relief. Urolift is an in-office procedure that can be performed under either local anesthesia or sedation. Current studies show good durability up to 6 years and maybe even longer but results may not always be permanent and require repeat procedures in the future if symptoms return.

Rezum ™ , or Prostate Water Vapor Therapy – Also for patients with mild to moderate prostate enlargement and BPH symptoms, another new treatment for BPH is Rezum therapy. Your urologist will utilize a radiofrequency device to deliver pressurized water vapor into the prostate tissue. Over time, this water vapor and the energy it releases will cause BPH-related prostate tissue cells to die and eventually create an open channel in the urethra for relief of urinary symptoms. Similar to the UroLift, this procedure can also be performed in the office with local anesthesia or sedation. The recovery period can take up to one month.

Holmium Laser Enucleation of the Prostate (HoLEP), is a newer procedure performed to remove the portion of your prostate that causes your urinary symptoms. Unlike the UroLift or Rezum therapies, HoLEP requires anesthesia and sedation in the operating room. HoLEP is performed whenever patients have moderate to severely enlarged prostates. HoLEP was historically developed as a response to patients with prostates that were too large to be addressed in a minimally invasive manner, requiring open surgeries and incisions. Since then it has gained traction as a preferred treatment method for prostates of all sizes due to its flexibility in technique and its ability to be performed without the need for incisions or cuts. While treatments such as UroLift and Rezum focus on addressing certain portions of the prostate, HoLEP aims to completely remove all portions of the prostate that are responsible for BPH and urinary symptoms. If you think of the prostate as an orange, the HoLEP aims to remove the “fruit” portion and preserves the “peel.”

Prostate Artery Embolization (PAE) – PAE is a procedure performed by an interventional radiologist who may sometimes work closely and collaborate with a urologist. By using an artery in either your wrist or groin, the radiologist can access the arteries that feed your prostate and embolize them, decreasing and cutting off the blood supply. Over time, after completion of the procedure, the prostate will gradually shrink, leading to reduced BPH symptoms and sometimes symptom relief. Currently, prostate artery embolization, or PAE, is not recommended by the American Urological Association. This is due to concerns for radiation exposure, the need to access blood vessels and higher risk of bleeding, and the lack of sufficient high level evidence in scientific studies. Prior to proceeding with PAE, it is important to consult with your urologist to see if this procedure is right for you.

There are constantly new therapies and modalities for BPH and BPH symptom treatments being developed and it is important to be educated about each one to find out if they will be effective against your specific case of enlarged prostate. Doctors Shaw and Tsai at Austin Urology Institute are on the forefront of emerging, advanced, and effective treatments for BPH and take great pride in helping patients navigate through their BPH treatment journey. Not every patient or prostate is alike and the doctors and staff at Austin Urology Institute are available to help tailor treatments that are specific to you.

To find relief from your symptoms with a minimally invasive procedure, get in touch to book a consultation.