BPH or Enlarged Prostate — Other Treatment Options

Other treatment options for BPH or enlarged prostate include a variety of surgical options, thermotherapy, and a number of nonsurgical treatment options.

Surgery is primarily used in men with severe symptoms of BPH or enlarged prostate or a complicating factor, including:

• Bleeding from the prostate
• Bladder stones
• Frequent urinary tract infection
• Urinary retention
• Kidney damage caused by urinary retention

Although BPH or enlarged prostate surgery can be associated with side effects, including impotence or loss of bladder control, most men do not experience serious long-term problems due to this type of treatment. However, repeat surgeries are sometimes necessary.

Thermotherapy is a broad term that includes a number of treatment options that use heat to destroy excessive prostate tissue. There are several types of thermotherapy:

• Microwave therapy uses heat in the form of microwave energy to destroy the inner portion of the prostate gland. After this procedure, the use of a catheter may be required for several days. This procedure generally does not cause impotence, incontinence, or retrograde ejaculation.
• Radiofrequency therapy uses radio waves sent through needles to heat and destroy prostate tissue. Radiofrequency therapy does not cause incontinence or impotence, but there is a small risk of retrograde ejaculation.
• Electrovaporization uses high-frequency electrical current to cut and vaporize excess prostate tissue. During cutting and vaporization, the electrical current also seals off the tissue to limit or prevent bleeding.
• Laser therapy is similar to other thermotherapies, except that a laser is used instead of microwave energy, radio waves, or electrical current. Laser therapy usually does not cause impotence or prolonged incontinence.

Nonsurgical treatment options for BPH or enlarged prostate are available for men who are reluctant or unable to undergo surgery, or who are unable or unwilling to take medication. One of the most common methods is the use of prostatic stents, which are tiny metal coils placed into the urethra to widen it and keep it open. Tissue will grow over the stent to hold it in place. This procedure only takes about 10 to 15 minutes, produces little or no bleeding, and does not require a catheter. Some men have not experienced any improvement in their symptoms after placement of the stent. In addition, other men have had frequent urinary tract infections or experienced irritation when urinating. This procedure is usually reserved for critically ill or very elderly patients with urinary retention.