Conventional versus surgical treatment of benign prostatic hyperplasia

Conventional versus surgical treatment of benign prostatic hyperplasia

Enlarged prostate gland affects men’s ability to urinate, and thus their quality of life. Benign prostatic hyperplasia, or BPH, is a progressive disease, which means that symptoms may aggravate over time without proper treatment. Treatment of benign prostatic hyperplasia includes watchful waiting, pharmacotherapy, minimally invasive interventions, and surgery. Lifestyle changes are also helpful in preventing or improving symptoms. It should be mentioned that homeopathy, acupuncture or herbal treatments are not proven to be efficient and safe enough, so they are not included into the approved protocols.

Pharmacotherapy

Administration of medications is the most common first-line treatment option for mild to moderate clinical manifestations of prostate enlargement. The following drugs are used in the monotherapy or combined schemes:

  1. Alpha-adrenergic blocking agents that relax muscles of bladder neck and prostate, reducing pressure on the urethra and facilitating urination. These drugs (e.g. alfuzosin, doxazosin, tamsulosin, and silodosin) usually work quickly in patients with relatively small prostate glands. It should be mentioned that side effects might include retrograde ejaculation (a harmless condition when semen goes up into the bladder instead of coming out the penis).
  2. 5-alpha reductase inhibitors shrink the prostate by blocking hormonal changes that stimulate prostate growth. Such medications include finasteride and dutasteride. The therapeutic course may last for up to six months. Side effects also include retrograde ejaculation.
  3. Combination drug therapy includes taking 5-alpha reductase inhibitor and alpha blocker at the same for enhancing their cumulative effect.

In addition, tadalafil may also be applied for the treatment of benign prostatic hyperplasia. This medication is traditionally used for erectile dysfunction treatment. Its influence on the prostate enlargement is investigated in the ongoing studies.

Minimally invasive and surgical treatment

Treatment of BPH in Germany includes a number of minimally invasive or surgical procedures. They are considered if prostatic hyperplasia causes moderate to severe symptoms that are not relieved with medications, urinary tract obstruction or bladder stones, blood in urine, etc. Such therapeutic options are also applied if a patient prefers definitive treatment.

The spectrum of minimally invasive and surgical urological interventions, which are performed under the ultrasound or tomography control, includes:

  1. Transurethral resection of the prostate (TURP).
  2. Transurethral incision of the prostate (TUIP).
  3. Transurethral microwave thermotherapy (TUMT).
  4. Transurethral needle ablation (TUNA).
  5. Laser therapy, including ablative (HoLAP) and enucleative (HoLEP) procedures
  6. Prostatic urethral lift (PUL).
  7. Embolization of prostate vessels.
  8. Open or robot-assisted prostatectomy.

Minimally invasive and surgical urological interventions are not indicated if a patient has an acute urinary tract infection, prostate irradiation or urinary tract tumor in the anamnesis, urethral stricture, multiple sclerosis or Parkinson’s disease, etc.

Planning treatment abroad with Booking Health

Patients from abroad can undergo treatment of BPH in Germany with the help of Booking Health, the certified medical tourism provider. Booking Health assists men and their relatives in such important aspects:

  • Choosing the right urological clinic based on its annual qualification profile.
  • Establishing communication with treating physician.
  • Booking the appointment on the convenient date.
  • Preparing medical program in advance, including consultations of related specialists (e.g. oncologist, cardiologist, etc.).
  • Further monitoring of medical program at all stages.
  • Providing favorable prices, without additional coefficients for foreign patients (saving up to 50%).
  • Control of invoices and return of unspent funds.
  • Help in buying medicines, medical products, etc.
  • Communication with the clinic and physician after treatment completion.
  • Organization of additional examinations, distant consultations.
  • Service of the highest level: booking hotels and plane tickets, transfer organization.

To start planning treatment, please, leave your request on the website of Booking Health. A competent patient case manager or medical advisor will contact you the same day.

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