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There's big money in treatments for an enlarged prostate, also known as benign prostatic hyperplasia. Witness the steady stream of TV ads for drugs to curb the urinary symptoms that mark the condition. And the expected introduction soon of a new drug, silodosin (Rapaflo), into an already crowded field. Of course, what's good for drugmakers isn't always best for consumers. While drug therapy can be a good option for some men who have grown weary of multiple nightly trips to the bathroom, other options for enlarged prostate treatment are often better.
Keep it simple. An enlarged prostate gland can lead to a weak or sputtering urine stream by pressing against the urethra or by triggering spasms in the muscle that surrounds it. Any man who suffers from those symptoms should see a doctor, since they can sometimes signal diabetes or even cancer. When such causes are ruled out but the symptoms continue to bother you, try these simple measures:
Drugs and surgery. If those strategies for enlarged prostate treatment don't help, one of the drugs described in the chart below often will. When symptoms persist despite drugs and lifestyle changes, you could consider one of the procedures listed in the chart below.
Treatments | Possible side effects | Recommendations |
---|---|---|
Medications | ||
Alpha-blockers: Alfuzosin (Uroxatral), doxazosin (Cardura and generic), tamsulosin (Flomax), and terazosin (Hytrin and generic). | Dizziness, especially upon standing, and reduced ejaculate volume. Might interact with erectile dysfunction drugs to cause dangerously low blood pressure. |
|
5-alpha-reductase inhibitors: Dutasteride (Avodart) and finasteride (Proscar and generic). | Erectile dysfunction and reduced ejaculate volume. Reduces prostate-specific antigen (PSA) levels, so test interpretation should be adjusted (typically by doubling the measured level, then interpreting as usual). |
|
Surgery | ||
Transurethral resection of the prostate (TURP): removal of tissue around the urethra. Transurethral incision of the prostate (TUIP): incisions made on the prostate to relieve pressure on the urethra. Holmium laser enucleation of the prostate (HoLEP): destruction of prostate tissue with light energy. Photoselective vaporization of the prostate (PVP): destruction of prostate tissue by green-light laser. |
Retrograde ejaculation, in which semen goes back into the bladder rather than out through the penis, is more common with TURP and can cause infertilty. Erectile dysfunction and urinary incontinence occur only rarely. |
|
Minimally invasive procedures | ||
Transurethral microwave therapy (TUMT): microwave energy to destroy prostate tissue. Transurethral needle ablation (TUNA): heat from high-frequency radio waves to destroy prostate tissue. |
Lower risk of major side effects than with surgery, though urine-retention problems can arise after treatment. More likely than surgery to lead to recurrence and retreatment. |
|
This article first appeared in the March 2009 issue of Consumer Reports on Health.
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