Increased Risk of Heart Disease and BPH Medications

March 3, 2021

Benign Prostatic Hyperplasia (BPH) is a common medical condition that affects
about 40 million men in the U.S. As the prostate grows and enlarges benignly (BPH) it begins to press on and obstruct the urethra causing symptoms such as frequent daytime urination, getting up at night frequently to urinate, a weak or slow stream, the feeling of not emptying the bladder completely, an urgent need to urinate or difficulty starting a urinary stream. Although BPH is a benign condition, many men find it disruptive to their lives.

Typical treatment options include taking a daily medication (alpha blockers) that can help reduce or eliminate symptoms or surgical options that are effective in eliminating symptoms entirely. Most often, this is the first step in treatment is taking medication. However, some new research points to a link between the medications (alpha blockers) used to treat BPH and a small, but significant increase in the probability of developing heart failure.

It was found that men treated with alpha blockers for BPH were more likely to develop heart failure by 22%. However, it was found that risk factors such as previous heart disease, high blood pressure, and diabetes had a much greater impact on heart failure risk compared with BPH medications.

It’s not as simple as a direct link, but this slight increase and those with risk factors may have better results and less risk of heart failure if considering surgical options.

If you are ready to dump your medications for BPH or prefer other treatment options without the risk of developing heart disease there are surgical options to treat BPH, as well. Research has shown that Urolift tends to have the most favorable outcomes when it comes to fast urinary improvement, little recovery time, reliability of preservation of sexual function and a quick return to normal lifestyle. Below are the different surgical procedures used to treat BPH.

Urolift USED to be the new kid on the block, but now it has some competition. Urolift is a very simple procedure to help with BPH. Urolift is typically a one-time, in-office solution that provides rapid relief and recovery of BPH symptoms. It provides a less invasive treatment option for BPH than a TURP. Along with less risk, Urolift also diminishes the concern about anesthesia and possible lasting erectile or ejaculatory dysfunction that a TURP could potentially cause. As Urolift has been studied more thoroughly it has become the surgical treatment option of choice for most urologists.

It works by implanting small “stents” that lift and hold the enlarged prostate tissue so it no longer blocks the urethra. It does not require heating, cutting, or removal of the prostate tissue. The procedure takes under 30 minutes and is performed using local anesthesia in a physician’s office.

Research has demonstrated that after one month approximately 80% of men that had the Urolift procedure performed described their BPH symptoms as “much” or “very much better.” And 89% would recommend the procedure. Recovery time tends to be shorter than a TURP with improved urination in about two weeks and a catheter is most often not used post procedure. The Urolift procedure is not appropriate for all patients, but for most, it’s an alternative option to a TURP.

The old standby. Tried and true the TURP or transurethral resection of the prostate tissue has been performed for decades and is a great surgical option. The TURP works by removing the obstructing prostate tissue. It’s performed in a surgical center and under general anesthesia. The surgery is simple, outcomes are well studied and come with a low risk of changes in sexual function. Recovery time is a bit slow, as the prostate tissue must heal and scar over post surgery with moderate restrictions on activity level for a few weeks, often taking up to 3 months to fully gauge urinary changes.

Prostatic artery embolization (PAE)
PAE is a very new addition for the treatment of BPH. Post surgical outcomes have been widely variable in research and, although PAE appears to be a treatment option for BPH in the future, most agree, more studies need to be done before stacking it against a TURP or Urolift or Rezum as a recommended treatment option in terms of safety and effectiveness. PAE is a minimally invasive treatment. The PAE procedure is performed by an interventional radiologist. PAE is then performed through a small catheter inserted nto the artery in the wrist or groin. The interventional radiologist guides the catheter into the vessels that supply blood to the prostate. An X-ray with dye (arteriogram) is performed to map the blood vessels that “feed” the prostate. Tiny round microspheres (particles) are injected through the catheter and into the blood vessels that feed the prostate to reduce its blood supply. Ideally, following this procedure, the prostate begins to shrink, relieving and improving symptoms usually within days of the procedure. It received FDA approval relatively recently and is not widely used yet, as patient outcomes and complications vary greatly in research.

Rezum is another new option for the treatment of BPH. Rezum works to improve urinary symptoms by inserting sterile water vapor (steam) into the prostate gland during nine second intervals. The procedure consists of two to seven injections, each nine seconds long. This vapor disperses between cells, then cools, releases heat, and gently disrupts the prostate’s cells. The procedure takes one to two hours in the office–depending on the size of the prostate. Urinary benefits usually are seen within a few weeks and improving over the following months.

For more information about BPH and BPH treatment options, contact Austin Urology Institute at (512) 694-8888 to make an appointment with a provider.