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BPH Treatment Options

If you have been diagnosed with an enlarged prostate due to BPH, consult with your physician to determine which treatment is right for you.

Treatment Options May Include:

Watchful Waiting: Watchful waiting involves making behavioral changes such as decreasing your fluid intake prior to bedtime, regular physical activity, and avoiding caffeine and alcohol. For men with mild symptoms this may be a viable option until their condition shows signs of worsening.1 However, it is important to note that, in a study, 87% of men who elected watchful waiting experienced a worsening of symptoms over a 4-year time period.2

Medications: Your doctor may prescribe BPH medication, just one or even a combination of BPH medications that may help alleviate your urinary symptoms. These medications are effective and may improve your BPH symptoms; however, some men may not experience enough relief. In addition, some men experience bothersome side effects from BPH medication. Either or both of these things may lead them to discontinue the medication.3-6 

Some patients may suffer side-effects including dizziness, headaches, or sexual dysfunction. Some may not get adequate relief of their symptoms. Over 16% of men on medication for BPH discontinue treatment early for reasons such as being dissatisfied with side-effects or not getting adequate symptom relief.1

Minimally Invasive treatments: These are procedures which can often be done as an outpatient procedure with milder forms of anesthesia than what is used in a hospital operating room. They typically have fewer complications than traditional surgery.7

The UroLift® System uses small implants to open the prostate blockage and does not require heating or cutting tissue. The procedure is typically performed under local anesthesia in a doctor’s office and patients typically return home the same day without a catheter.6,8 The UroLift System offers rapid symptom relief with a low risk profile.6 As the procedure does not destroy tissue, recovery on average is more rapid than for TURP patients. It is the only leading BPH procedure shown to provide symptom relief while also preserving sexual function.*8-11Patients may experience short-term pelvic pain and light blood in the urine.6,7

* No instances of new, sustained erectile or ejaculatory dysfunction in the L.I.F.T. pivotal study. 

  • Another minimally invasive BPH treatment is Rezum™ Water Vapor Therapy. This is a form of thermal therapy in which the prostate is heated with steam. Another form of thermal therapy called Transurethral Microwave Therapy (TUMT) uses microwaves to destroy tissue.7 They can typically be done at a doctor’s office with local anesthesia and patients can usually go home the same day as the procedure. These procedures generally have fewer complications than traditional surgery. A catheter is typically required for a few days after the procedure and recovery may take a few weeks.11-13 

Traditional Surgery: Common traditional BPH surgeries include transurethral resection of the prostate (TURP) and laser photoselective vaporization of the prostate (GreenLight™ laser PVP). These procedures are the most aggressive treatment option and can be effective. Recovery can take time and is accompanied by a higher risk of complications.1 Less commonly performed surgeries include Aquablation® therapy and Holmium Laser Enucleation of the Prostate (HoLEP).7 Aquablation® therapy uses a high-pressure water jet to remove prostate tissue, whereas HoLEP uses a laser to remove the prostate tissue. Traditional surgery can offer significant relief of symptoms and help you improve quality of life.1 

Rezum and GreenLight are trademarks of Boston Scientific. Aquablation is a trademark of PROCEPT BioRobotics Corp.

References  

*No instances of new, sustained erectile or ejaculatory dysfunction in the L.I.F.T. pivotal study

  1. AUA BPH Guidelines 2003. Updated 2010.
  2. Djavan, Urology 2004
  3. Chang DF, Campbell JR, J Cataract Refract Surg. 2005
  4. Duan et al, Pharmacoepidemiol Drug Saf. 2018
  5. Welk et al, JAMA Intern Med. 2017
  6. Roehrborn, J Urol 2013
  7. Roehrborn, Can J Urol 2017
  8. Shore Can J Urol 2014 
  9. Tutrone, Can J Urol 2020 
  10. Eure, et al., AUA 2020
  11. Sonksen, et al., Eur Urol 2015 
  12. McVary, J Urol 2016
  13. McVary, J Urol 2020; AUA abstract LBA01-06 5-year Rezum 

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