New Treatments for BPH and BPH Symptoms

June 2, 2020

BPH, or Benign Prostatic Hyperplasia, and its associated lower urinary tract symptoms, is a common condition that may affect men as early as age 30. As the prostate is an organ specific to males, it is also considered a “lifelong friend or enemy” that will either cause urinary symptoms or in some cases develop cancer. Unless it is treated or removed, a prostate will

BPH has been present as long as the human male has existed. Consequently, innumerable treatments have been developed as a response to BPH and its symptoms. In fact, a comprehensive textbook could be written on the history of and treatments for BPH. In light of this, the general trend as technology and newer techniques develop has been geared towards treatments and procedures that provide maximal results and benefits with the most minimally invasive approaches.

There is a wide variety of treatments available for BPH including medications, in-office procedures, and operating room surgeries. Newer choices for treatments tend to be less invasive, more comfortable, and as efficacious as older options.

Prior to proceeding towards procedures or surgery, BPH is often treated medically with oral medications. Medications such as tamsulosin, alfuzosin, silodosin, and finasteride have been available for many years. While these medications often help patients feel better and help with symptoms, they often do not completely resolve their issues and have untoward side effects such as reduction in sexual function. This is often due to the fact that the prostate or BPH has worsened to the point where medications are no longer effective.

Newer procedures for BPH have recently come to the forefront and serve as alternatives to medications and larger surgeries.

  1. 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.
  2. 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 1 month.
  3. Holmium Laser Enucleation of the Prostate (HoLEP), is a newer minimally invasive 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.”

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 and suit you. 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.