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.
Minimally Invasive Treatments for an Enlarged Prostate continued...
TUNA (transurethral radio frequency needle ablation): This procedure also destroys prostate tissue to improve urine flow and relieve symptoms. It involves heating the tissue with high-frequency radiowaves transmitted by needles inserted directly into the prostate (some anesthesia is used). The procedure does not require a hospital stay. Possible side effects include painful, urgent, or frequent urination for a few weeks.
Prostatic stents: In some cases, a tiny metal coil called a stent can be inserted in the urethra to widen it and keep it open. Stenting is done on an outpatient basis under local or spinal anesthesia. Usually, stents are only for men who are unwilling or unable to take medications -- or who are reluctant or unable to have surgery. The majority of doctors don't consider stents a good option for most men.
There could be serious side effects, and some men find that stents don't improve their symptoms. Sometimes a stent shifts position, which can worsen the symptoms. In some cases, men experience painful urination or have frequent urinary tract infections. Stents are expensive, and there can be difficulty in removing them.
Surgery for an Enlarged Prostate
For most men with very enlarged prostates, surgery can relieve symptoms -- but there are both risks and benefits with each type of operation. Discuss them with your doctor. After a careful evaluation of your situation and your general medical condition, your doctor will recommend which is best for you.
TURP (transurethral resection of the prostate): This is the most common surgery for an enlarged prostate, and considered to bring the greatest reduction in symptoms. Only the tissue growth that is pressing against the urethra is removed to allow urine to flow easily. The procedure involves an electrical loop that cuts tissue and seals blood vessels. Most doctors suggest using TURP whenever surgery is required, as it is less traumatic than open surgery and requires shorter recovery time.
With the TURP procedure, patients can expect to have retrograde ejaculation afterwards, says Westney. This is a condition in which a man ejaculates backward into the bladder instead of through the urethra. "Retrograde ejaculation generally isn't painful," she tells WebMD. "It shouldn't be an issue unless fertility is a concern." Other possible side effects include blood loss requiring transfusion (rare), painful urination, recurring urinary tract infections, bladder neck narrowing, and blood in the urine.