Benign Prostatic Enlargement
- Treatments
Benign Prostatic Enlargement (BPE) treatment may not be needed in mild cases. In moderate to severe cases, the following treatment options are available:
Drug Treatment
Drugs that relax the smooth muscle of the prostate and bladder neck are Transurethral resection of the prostate (TURP) is the most common technique used to treat BPE. used to improve urine flow and reduce bladder outlet obstruction. Drugs that inhibit production of the male hormone DHT, which is involved with prostate enlargement, are used to prevent progression of growth of the prostate or actually shrink the prostate in some men.
Surgical Treatment
Most urologists recommend removal of the enlarged part of the prostate as the best long-term solution for someone with Benign Prostatic Enlargement (BPE). With surgery for BPE, only the enlarged tissue that is pressing against the urethra is removed; the rest of the inside tissue and the outside capsule are left intact. Surgery may be performed by the following methods:
-
Transurethral resection of the prostate (TURP).
This is the most common technique used in 90 percent of all prostate surgeries for BPE. Under anaesthesia, a resectoscope is inserted through the penis. The surgeon uses the resectoscope with a special wire loop or laser fibre to remove the obstructing tissue one piece at a time. The pieces of tissue are carried by the fluid into the bladder and then flushed out at the end of the operation.
-
Open surgery.
In some cases when a transurethral procedure cannot be used or if the gland is extremely large, open surgery may be needed. Under anaesthesia, the surgeon makes an incision in order to reach the prostate capsule to scoop out the enlarged tissue from inside the gland. -
Laser vaporisation.
A laser fibre is passed through the urethra into the prostate using a cystoscope and bursts of laser energy are delivered to destroy the prostate tissue. As with TURP, laser surgery requires anaesthesia and a hospital stay. This technique is often used for selected people with smaller glands. At the end of surgery, a urinary catheter is inserted through the opening of the penis to drain urine from the bladder into a collection bag for a few days.
Sexual Function After Surgery
Most men are able to continue to have erections after surgery. After prostate surgery, the neck of the bladder is widened, so the semen takes the path of least resistance and enters the wider opening to the bladder rather than be expelled through the penis. Later, it is harmlessly flushed out with the urine. The main impact of prostate surgery is that you will not be able to father children in the normal way as you have a dry ejaculate. However, most men find little or no difference in the sensation of orgasm or sexual climax after surgery.
