Men suffering from BPH urinary symptoms usually require treatment. Their findings indicate that the need for early avodart generic name
treatment may be omitted, as BPH symptoms disappear without treatment in more than 1/3 of all mild cases of BPH. Instead of immediate treatment they offer regular check-ups to monitor the appearance of the symptoms of BPH. If the state begins to endanger the patient's health or cause patient anxiety, usually prescribed treatment.
Since BPH may be the cause of urinary tract infections, a physician to treat a urinary tract infection with antibiotics before start treatment of BPH. Urologists are advised to start treatment of BPH, as soon as symptoms become bothersome or pose a threat to the patient's health. The following section describes methods for treating BPH.
In recent years, researchers are trying to find a way to reduce or at least stop the growth of the prostate without using surgical treatment of BPH. There are six drugs to reduce severity of main symptoms associated with enlargement of the prostate.
Finasteride (Alfinal, Penester, Proscar, Prosterid, Finasta) and Dutasteride (Avodart) inhibit the secretion of dihydrotestosterone, a hormone that is associated with an enlarged prostate. Use of finasteride or dutasteride, or may prevent the development of prostate enlargement, or to reduce the size of enlarged prostate in some men.
For the treatment of BPH is also used terazosin (roots, Setegis, Haytrin, Gitrin) Doxazosin (Artezin, Doxazosin Vero, Doksaprostan, Zokson, Camiri, Kardura, Kardura CL Kardyura, Magurol, Tonokardin) Tamsulosin (Flomax, hypersimple, Omnic, Omnic Okas, Revokarin, Tamsulon-FS Fokusin, Omsulozin) and alfuzosin (Uroksatral, Dalfaz). All four of drugs relax the smooth muscle of the prostate and bladder neck to improve urine flow and decrease obstruction of the bladder. Terazosin, doxazosin, alfuzosin Tamsulosin and belong to the class of alpha-blockers. Terazosin and Doxazosin originally used as drugs that lower blood pressure. Tamsulosin and alfuzosin are specifically designed for the treatment of BPH.
Using a combination of finasteride and doxazosin more effectively reduces the severity of urinary symptoms and prevent progression of BPH. The combination of the two drugs reduces the risk of BPH progression by 67% compared with 39% in the treatment only 34% of doxazosin and in the treatment of BPH only finasteride.
Minimally invasive treatment of BPH
Due to the fact that the drug therapy in the treatment of BPH is often not effective, developing minimally invasive treatments for BPH in recent years.
Microwave BPH therapy (transurethral microwave therapy). In 1996, it was created by a device that generates microwaves to heat and destroy prostate tissue. During transurethral microwave thermotherapy (TUMT), a computer device sends microwaves adjusted through the catheter to heat selected portions of the prostate to 44 degrees Celsius. During transurethral microwave treatment of BPH urinary tract from overheating protects the cooling system.
Microwave therapy for BPH takes about 1 hour and can be performed on an outpatient basis under local anesthesia. Transurethral microwave therapy does not cause erectile dysfunction or urinary incontinence in men.
Although transurethral microwave therapy does not cure BPH, it reduces urinary frequency, urgency, stress and erratic flow of urine. Transurethral microwave therapy does not solve the problem of incomplete emptying of the bladder. To determine the long-term effects of transurethral microwave therapy in the treatment of BPH research is needed.
Transurethral needle ablation for BPH (TUNA)
Also, since 1960, it applied transurethral needle ablation for the treatment of BPH. In transurethral needle ablation to heat the prostate tissue using radio waves. Under visual control using a cystoscope is placed into the prostate a tiny needle through which a radio wave. From high temperature damage the urethra protect special screens. Transurethral needle ablation for BPH reduces the severity of urinary symptoms with fewer side effects compared with transurethral resection of the prostate (TURP). In men after transurethral needle ablation for BPH have been recorded of impotence or incontinence.
Transurethral Thermotherapy BPH
In transurethral thermotherapy for destruction of overgrown prostate tissue using heated water. Hot water circulated through the balloon catheter, which is inserted into the urethra and is set so that the balloon is projected on the center of the prostate. The computer controls the temperature of the water that circulates through the balloon and heat the surrounding tissue. The system directs the action of heat to certain areas of the prostate. Tissue surrounding the urethra and bladder reserved. Destroyed prostate tissue through the urethra displayed or reabsorbed by the body.
High-intensity focused ultrasound (HI-FU)
High-intensity focused ultrasound for the treatment of BPH is still undergoing clinical trials.
Surgical treatment of BPH
Most doctors recommend removal of the enlarged part of the prostate gland as a more efficient, with the best long-term results of treatment of patients with BPH. During surgery for BPH only removed overgrown prostate tissue which compresses the urethra, the remaining part of the prostate tissues and its capsule are left intact. After surgical treatment of BPH is reduced obstruction and incomplete bladder emptying. The following section describes the types of operations that are used to treat BPH.
Transurethral prostate surgery
In transurethral surgery of the prostate gland there are no external incisions. After the anesthesia the surgeon reaches the prostate by introducing instruments through the urethra.
Transurethral resection of the prostate (TURP) is used in 90% of cases in the treatment of BPH. During TURP resectoscope is inserted through the urethra. resectoscope length of about 30.5 centimeters in diameter - slightly more than one centimeter. Resectoscope includes a light source for the liquid valves, which wash operation region, the electric loop, through which the removed tissue and coagulate blood vessels.
During the 90-minute operation TURP, the surgeon uses an electric loop resectoscope to remove tissue that blocks the urethra, one piece at a time. Pieces of fabrics washed in the fluid bladder, which is washed at the end of the operation.
Transurethral surgery for BPH less traumatic than open forms of surgery and require a shorter recovery period. One of the possible side effects of TURP - a retrograde ejaculation. If retrograde ejaculation the semen during ejaculation instead of flowing back of the urethra into the bladder.
Transurethral incision of the prostate
In transurethral incision of the prostate tissue instead of removing the prostate, both during TURP, perform a few small sections of the bladder neck and directly into the prostate tissue. Although after transurethral incision of the prostate decreased urinary symptoms severity and frequency of side effects, such as retrograde ejaculation, its long-term effectiveness and advantages, at present, is not clearly established.
In those cases where the transurethral prostatic surgery can not be used in the treatment of BPH, open prostatectomy performed, during which requires an external incision. Open prostatectomy is indicated for large size of the prostate or if the bladder is damaged and you need to restore it. Localization increased tissue within the prostate gland helps the surgeon to decide which of the three methods of open surgery is necessary to choose.
As during every open operation is first carried out anesthesia, and then perform the cut. Once the surgeon reaches the prostate capsule, he scrapes the inside overgrown prostate tissue.
Removal of BPH with laser
Since 1996, it applied surgical procedure that uses a laser fiber and side-firing Nd: YAG laser to vaporize the enlarged prostate tissue. The physician introduces a cystoscope using a laser fiber through the urethra to the prostate gland, and then spend several series of pulses of laser energy of 30 to 60 seconds. The laser energy destroys prostate tissue and eliminates the cause of the obstruction. Like TURP, laser surgery requires anesthesia and a hospital stay. One of the advantages of laser surgery, compared with TURP, a small hemorrhage. After laser surgery for BPH patients recover faster. However, laser surgery is used to treat benign prostatic hyperplasia large. The long-term effectiveness of laser surgery for BPH is unknown.
More recent treatments for BPH, which use laser technology, can be performed on an outpatient basis.
Photosensitive vaporization of the prostate
Photoselective vaporization of the prostate gland using a high-energy laser to destroy the prostatic tissue and isolate the treated area.
Interstitial laser coagulation of BPH
During interstitial laser coagulation BPH, unlike other laser procedures, the flexible optical fiber are placed directly into the prostate tissue.