BPH Treatment

 They are usually first-line drugs.

Alpha reductase inhibitors : They act by preventing the conversion of testosterone to its active form, dihydrotestosterone (DHT). In this way, it is reported that they reduce the prostate to a certain extent. Side effects include loss of libido, impotence (loss of sexual function), breast enlargement and tenderness, and decreased sperm count.

Alpha-blockers : They cause dilation of the urinary tract by relaxing the smooth muscle structures in the bladder neck and prostate. It is taken orally once a day. Side effects may include headache, dizziness, fatigue, weakness, and drop in blood pressure.

Transurethral Prostate Resection (TUR-P): Transurethral Resection of the Prostate is the most commonly used method in the surgical treatment of benign prostatic enlargement (BPH). In this method, after general or lumbar (spinal or epidural) anesthesia is given to the patient, a special instrument called a resectoscope is entered through the urinary tract and the prostate tissues are cut using electric current. Irrigation fluid must be used continuously during this operation, which is performed with images magnified 10-12 times by transferring the images inside the patient to a television monitor via an optic. The electric current is transmitted to the tissues through a semicircular wire called a “loop” and while the prostate tissue is cut into strips, bleeding is stopped with the help of a loop. Prostate tissues accumulating in the urinary bladder are then removed by the vacuum system.

TUR-P operation

Open Prostatectomy:  Open prostatectomy is the surgical removal of an enlarged (non-cancerous) prostate. It is performed under general or spinal anesthesia. An incision is usually made in the lower abdomen, sometimes between the rectum and the base of the penis. A catheter may be inserted through the skin of the lower abdomen into the bladder to aid in bladder emptying (post-operative bladder washing), and another probe emerges from the penis to drain urine. The procedure requires a slightly longer hospital stay and recovery time than the transurethral prostate resection method (TURP).

Open prostatectomies may only be required in men with very enlarged prostate glands (which may be more effective than TURP in clearing the obstruction of the urinary flow), men with bladder diverticulum or stones, and when TURP is not possible. Prostatectomy also reduces the possibility of needing another surgery, which is a potential problem when using TURP, but open prostatectomy cannot be performed if you have prostate cancer surgery.

Non-Surgical Treatment of Prostate Enlargement: Thermotherapy

Thermotherapy treatment, which is one of the newest and most modern methods in prostate enlargement, was started. The most striking feature of thermotherapy treatment is that it provides an effective treatment opportunity without putting patients at risk of surgery and general anesthesia and without requiring hospitalization.

Treatment Method Advantages of Thermotherapy

After a catheter-like catheter is placed into the prostate from the urinary tract and local anesthesia is performed, an average of 60 minutes is applied by injecting the energy produced by the device from the same catheter into the prostate in a very safe way. This procedure, which can be performed even in outpatient conditions, does not cause any uneasiness in the patient. In addition, unlike other surgical treatments, the patient can urinate after the procedure. The patient can go home by giving a prescription at the end of the procedure.

Advantages of Thermotherapy, Efficiency and Safety of Thermotherapy

The most important advantage is that it can be performed with local anesthesia without the need for general anesthesia and spinal anesthesia. Also, it has very few side effects. Therefore, it is an excellent method for patients who are elderly, have high-risk diseases such as heart disease, Alzheimer’s, stroke, use anticoagulants and have a risk of bleeding, and have a permanent catheter inserted. It is also an excellent alternative treatment for younger risk-free patients who are afraid of surgery. Because it has very low side effects. It is also the only method in the treatment of a chronic prostatitis.

Efficiency and Safety of Thermotherapy

Thermotherapy treatment is one of the alternative treatment methods offered by the European Urology Association (EUA) and the American Urology Association (AUA) instead of surgical interventions. Thermotherapy and surgical treatments (TUR-Prostatectomy) were compared in studies conducted in Europe, and the patients were followed for 3 months to 60 months. The mean symptom score increase (reduction in prostate complaints) was 65% in thermotherapy and 77% in TUR-Prostatectomy. While this result is close to surgery, it shows the superiority of thermotherapy treatment due to its low risk and absence of side effects. In addition, the absence of side effects such as death, urethral stenosis, and impotence caused by the surgery is one of the advantages of the method.

Since it is a daily treatment, it is a method that can be easily applied to any patient from anywhere in Turkey.