What’s the best treatment for an enlarged prostate?

Benign prostatic hyperplasia or prostate gland enlargement is a common condition as men get older. It can cause uncomfortable urinary symptoms, such as blocking the flow of urine from the bladder, urinary tract and kidney problems. Not all patients with an enlarged prostate need treatment and in many cases, prostate cancer isn’t the underlying cause of an enlarged prostate.

Urologist Mr Chis Blick talks about the best way to treat an enlarged prostate from Rezum to UroLift.

In the past, a type of surgery called TURP or medication was used to treat an enlarged prostate, but now there are many new technologies to treat an enlarged prostate gland. Prostate treatment is now very much patient-specific and personalised.

For smaller prostates, less invasive options like Urolift and Rezum can benefit patients, and limit side effects regarding erectile and ejaculatory function and continence. Larger prostates tend to need laser treatment and in certain cases, prostate artery embolization or robotic surgery to remove the enlarged part of the prostate.

Is rezum an effective treatment?

Rezum is an effective treatment for an enlarged prostate and can be carried out in one day. It involves injecting steam into the prostate to shrink its size, improving the patient’s urinary flow. Studies show that four years after treatment, urinary flow improves by 50% and the overall quality of life for patients also improves. It also preserves other functions such as erectile, ejaculatory and continence function.

What is the UroLift procedure?

The UroLift procedure is a minimally invasive procedure designed to improve urinary flow. It can be performed under local or general anaesthetic and involves inserting a camera into the urethra along with a number of implants called urolifts. This opens up the urethra or water pipe that was previously blocked by the prostate, improving the flow of urine by about 50%. UroLift also preserves sexual and continence functions.

UroLift can be carried out as a day case procedure and only takes between 10 and 15 minutes to perform and most men can go back to work within 48 hours. It’s effective for an enlarged prostate with a volume of up to 75ccs, (which is A majority of men) and for men who want to remain active and have a simple, minimally invasive day case procedure with little side effects.

When would prostate artery embolisation be considered?

Prostate artery embolisation is a procedure performed by radiologists to access the small arteries that supply the prostate. Very small beads are injected into the arteries, reducing blood flow to the prostate and causing the volume of the prostate to decrease. It’s ideal for patients with a prostate size of over 80ccs. It’s also ideal for patients who wish to avoid surgery to treat their enlarged prostate.

In summary, treatment for an enlarged prostate depends upon patient aspirations and their level of symptoms. For some, medication might be the answer. For patients who wish for a more permanent fix without medication, minimally invasive treatments such as UroLift or Rezum can be used for smaller prostates and laser treatment and prostate artery embolization for larger prostates.

Even with all of these treatments in mind, the goal is to reduce complications and side effects by preserving functions where possible.

If you’d like more information about the treatment of prostate enlargement or about Mr Chris Blick, visit his Top Doctors profile.