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BPH OVERVIEW > CURRENTLY AVAILABLE TREATMENT OPTIONS

Medical therapy consists of alpha-blockers which relax the muscles around the neck of your bladder, making it easier to urinate, and 5-alpha reductase inhibitors which act to shrink the prostate. While medications can be helpful in relieving symptoms for some men, patients must continue taking them long-term to maintain the effects. Some patients may suffer side-effects including asthenia, dizziness, headaches or sexual dysfunction1,2. Over 20% of men on BPH medication pre-maturely discontinue treatment for reasons such dissatisfaction with side-effects or inadequate symptom relief. Ultimately, the annual therapy cost may top $1,000 in cases in which combination drug therapy is applied.

Surgery consists of various methods of resecting or ablating the prostate tissue. While effective in expanding the urethral lumen and relieving symptoms, tissue resection or ablation also contribute to significant morbidity. Transurethral Resection of the Prostate (TURP) is currently the gold standard treatment, yet it is associated with a 20% rate of perioperative morbidity, need for general anesthesia, routine catheterization and long-term side effects such as dry orgasm (retrograde ejaculation), erectile dysfunction or incontinence (leaking of urine)2,3. TURP may be performed with a laser in procedures called photoselective vaporization of the prostate (PVP) or holmium laser enucleation (HOLEP). Laser therapy lessens the bleeding risks of traditional TURP. However, as prostate tissue is removed, there can be tissue swelling and an uncomfortable healing time. Typically, a catheter has to be inserted into the bladder after the procedure.

Since the introduction of minimally invasive surgical techniques, BPH treatment procedures have steadily shifted from the operating room to urologists’ office setting. In-office procedures are associated with faster recovery and increased patient comfort. Some minimal invasive techniques, called thermotherapies, apply heat energy, as microwave or radiofrequency (RF) to destroy prostate tissue. Being less invasive than TURP, these treatments are generally safe, can be performed under local anesthesia and provide moderate symptom relief for some patients. Applying high heat to the prostate can cause tissue swelling and uncomfortable urinary symptoms during the healing period. Symptom relief does not occur immediately, and patients often need to have a catheter attached to a urine bag, inserted into their bladder during the recovery period2,3.
A new, minimally invasive solution called UroLift, approached the US market in 2014. The procedure is based on a mechanical process of lifting the enlarged prostate towards the prostate capsule with no cutting, heating or tissue removal.


1 Hutchison, A. et al., Eur Urol 2007; 51: 207-216
2 Benign Prostatic Hyperplasia Guideline, Roehrborn, C.G., et al.: Guideline on the Management of Benign Prostatic Hyperplasia, American Urological Association Education and Research, Inc. 2003
3 Miano, R. et al., Med Sci Monit 2008; 14: RA94

 
 
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