Management and Treatment
- Watchful waiting: This means monitoring the condition without any active treatment, but making some lifestyle changes such as drinking less fluids at night, avoiding caffeine and alcohol, and urinating when you feel the urge. This option is suitable for men with mild or moderate symptoms who are not bothered by them.
- Medications: There are two main types of drugs that can help reduce the size of the prostate or relax the muscles around it, thus improving the urine flow. They are alpha-blockers (such as tamsulosin, alfuzosin, or doxazosin) and 5-alpha reductase inhibitors (such as finasteride or dutasteride). These medications can have side effects such as dizziness, low blood pressure, sexual dysfunction, or breast enlargement. They may also interact with other drugs, so it is important to consult with your doctor before taking them.
- Minimally invasive procedures: These are techniques that use heat, lasers, or implants to destroy or shrink some of the prostate tissue, thus relieving the obstruction. They are usually done under local anesthesia and have a shorter recovery time than surgery. Some of the examples are transurethral microwave therapy (TUMT), transurethral needle ablation (TUNA), water vapor therapy (Rezum), or prostatic urethral lift (UroLift). These procedures may have risks such as bleeding, infection, urinary retention, or erectile dysfunction.
- Surgery: This is the most effective option for men with severe symptoms or complications such as urinary retention, kidney damage, bladder stones, or recurrent urinary tract infections. Surgery involves removing part or all of the prostate gland through an incision in the abdomen or the urethra. The most common type of surgery is transurethral resection of the prostate (TURP), which uses an electric loop to cut and remove the excess tissue. Other types of surgery are open prostatectomy, holmium laser enucleation of the prostate (HoLEP), or robot-assisted laparoscopic prostatectomy (RALP). Surgery can have complications such as bleeding, infection, urinary incontinence, retrograde ejaculation, or erectile dysfunction.
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