Enlarged Prostate: A Complex Problem
There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect -- and how to decide.
Medications for an Enlarged Prostate continued...
The drugs: Flomax (tamsulosin), Uroxatral (alfuzosin), Hytrin (terazosin), Cardura (doxazosin), and Rapaflo (silodosin).
Alpha blockers were originally created to treat high blood pressure; dizziness is the most common side effect; other side effects are generally mild and controllable. Possible side effects include headache, stomach irritation, and stuffy nose. These drugs are not for men with significant urine retention and frequent urinary tract infections.
5-Alpha reductase inhibitors: These drugs can partially shrink the prostate by reducing levels of a male hormone -- dihydrotestosterone (DHT) -- which is involved in prostate growth. These drugs take longer to work than alpha blockers, but there is urine flow improvement after three months. These drugs can reduce risk of acute retention (inability to urinate) -- and also reduce the need for prostate surgery. You may need to take them for 6 to 12 months to see if they work.
The drugs: Proscar (finasteride) and Avodart (dutasteride).
Possible side effects include erection problems, decreased sexual desire, and reduced amount of semen. These side effects are generally mild and may go away when you stop taking the drugs -- or after the first year of taking the drugs.
There is also drug combination therapy, which may be effective against symptoms associated with BPH. Some examples of combined drugs include an alpha-blocker and a 5-alpha-reductase inhibitor; or an alpha-blocker and an anticholinergic.
Minimally Invasive Treatments for an Enlarged Prostate
When medications don't help your enlarged prostate, several procedures can relieve symptoms -- without surgery. They are performed in a doctor's office. "These procedures use various types of heat energy to shrink a portion of the prostate," explains Westney. "They are very effective."
TUMT (transurethral microwave thermotherapy): This therapy for mild to moderate blockage reduces urinary frequency, urgency, straining, and intermittent flow -- but does not correct any bladder-emptying problems. In this procedure, computer-regulated microwaves are used to heat portions within the prostate to destroy select tissue. A cooling system protects the wall of the urethra during the procedure. TUMT is performed in a doctor's office and requires only topical anesthesia and pain medications.
Possible side effects include painful urination for several weeks. Temporary urgency and frequency of urination is also possible. There may be less semen ejaculated. Many men must have this procedure repeated, either because symptoms return or do not improve.