Exploring what is the latest treatment for enlarged prostate 2023 reveals that while mild symptoms often respond to medications designed to relax bladder neck muscles and reduce prostate tissue, there can be side effects, including erectile dysfunction and low blood pressure. Meanwhile, many are also asking why does enlarged prostate cause frequent urination at night. In response to treatment needs, a cutting-edge nonsurgical procedure has been introduced to decrease the prostate’s blood supply, leading to its shrinkage and symptom relief. Expert interventional radiologists execute this innovative procedure.
The Role of Genomics in Personalized Therapies
There are many useful treatments for enlarged prostate (BPH), and some of them are less invasive than older options. These new choices often provide good results and comfortable recovery. They focus on stopping prostate growth, which is the cause of BPH symptoms.
Many people with a low risk of prostate cancer may choose watchful waiting instead of treatment. This allows them to avoid routine PSA tests, DREs, and biopsies. But they are monitored closely for signs that the cancer is getting worse or causing symptoms. If they do, treatment will start.
For those with mild to moderate BPH, prescription medications can be helpful. Some relax the bladder neck muscles and muscle fibers in the prostate, making urinating easier. Others shrink the prostate by lowering testosterone levels, though these might take up to six months to work and could also cause erectile problems.
If medicines don’t help, doctors can perform minimally invasive surgeries to remove the obstructing tissue. These include transurethral resection of the prostate (TURP), open prostatectomy, and robotic-assisted surgery. Another option is a permanent implant called the UroLift. It lifts the obstructing prostate tissue up and out of the way, leaving the urethra unobstructed.
Rezūm Water Vapor Therapy: A Closer Look
This is a new, minimally-invasive procedure that uses water to treat BPH. It has been shown to be safe, preserve sexual function and offer a high level of efficacy in patients with all different types of prostate gland morphologies. It is also easy to perform in an outpatient setting and has a low risk of self-limiting minor complications.
Rezum is a non-invasive procedure that can relieve the symptoms of an enlarged prostate, such as frequent urination and inability to urinate at night (nocturia). This procedure was recently approved by the FDA and is used by leading urology practices around the world.
During the Rezum procedure, your doctor will insert a small scope into your urethra and slowly manipulate it down to the base of the bladder while doses of sterile water vapor are released into your prostate. The water vapor instantly attacks cells in the prostate and kills them, allowing your prostate to shrink to its normal size and no longer obstruct the urethra.
This in-office treatment takes only minutes and can be done without the need for general anesthesia. Most people experience rapid relief of their enlarged prostate symptoms and can return to their daily lives with no interruption.
Aquablation: Benefits and Procedure
A heat-free waterjet controlled by robotic technology removes prostate tissue that’s causing symptoms. In some cases, the treatment also helps enlarged prostate glands stay smaller. The procedure is usually performed while the patient is under anesthesia. Most patients are discharged within a day of the surgery, compared to multiple days or weeks needed for recovery following traditional surgical procedures.
Men whose BPH symptoms are not relieved by medication may be candidates for Aquablation. It’s important for patients to be formally assessed and counseled by a urologist. This evaluation should include a Prostate Health Index (PHI), International Prostate Symptom Score (IPSS), and Uroflowmetry and TRUS examinations.
The Aquabeam system is the only one that combines a camera (cystoscope) with ultrasound imaging to enable surgeons to visualize each prostate in real-time. This allows surgeons to better plan their removal of prostate tissue and avoid irreversible complications such as urinary incontinence, erectile dysfunction, or dry ejaculation.
Aquablation is a new minimally-invasive procedure available at many AdventHealth hospitals. It is covered by Medicare and several private insurance companies. To learn if you are eligible for the treatment, call the phone number on the back of your insurance card or ask during a scheduled appointment with a urologist.
Prostate Artery Embolization PAE
Medications have been the go-to treatment for men with symptomatic benign prostatic hyperplasia (BPH). However, not all men get relief from medications. If symptoms persist, a urologist may recommend surgery. Surgical procedures like transurethral resection of the prostate (TURP) can be risky and require hospitalization.
A new and minimally invasive approach, prostate artery embolization (PAE), targets the blood vessels that supply the prostate. A physician called an interventional radiologist uses a small incision in your upper thigh or wrist to access the arteries. Using specialized X-ray equipment, the IR guides a catheter to the arteries that supply blood to the prostate. Embolic material the size of a grain of sand is then injected into the arteries to reduce the amount of blood that the prostate receives. This causes the prostate to shrink and improves urinary symptoms.
PAE is a safe procedure that has few reported side effects and requires only local anesthesia. It has also shown superior results in terms of reducing urinary frequency, improving lower urinary tract symptoms, and preventing the need for hemodialysis. Patients who are considered for PAE should undergo a thorough urologic evaluation to identify confounding factors of BPH that could decrease the likelihood of clinical success. This includes a comprehensive history, physical examination and review of medication and treatments.
Robot-Assisted Surgeries: Precision and Recovery
Robotic surgery allows doctors to use highly precise tools through small incisions, which reduces pain and recovery time. It may also offer other benefits, such as less blood loss and a shorter hospital stay. While many patients worry that a machine is performing the surgery, the robot only responds to the surgeon’s precise hand and finger movements. The doctor remains in the operating room throughout the procedure, controlling the robotic arm while seated comfortably at a console.
In the case of enlarged prostate, some types of surgical procedures are designed to remove excess tissue to prevent blockage and improve urine flow. These include transurethral resection of the prostate (TURP), which involves passing a device called a resectoscope through the urethra to remove part of the gland. Another option is open prostatectomy, which involves removing the entire prostate.
Other new treatments target the growth of prostate cells that causes BPH symptoms. For example, the Urolift implant offers a minimally invasive option to lift and hold the enlarged tissue out of the way of the urethra without affecting sexual function. It can also be used for people who do not want to undergo a surgical procedure. Talk with your urologist to find out what the best treatment options are for you.
Comparing Traditional and New BPH Treatments
Benign prostatic hyperplasia is a condition that causes your prostate to grow in size. It’s a gland about the size of a walnut that rests below your bladder and in front of the rectum, where it surrounds part of your urethra. The urethra is a tube that carries urine (pee) and sperm (ejaculate) out of the body. If your prostate grows too big, it can squeeze the urethra and cause painful symptoms.
Doctors offer several treatments to help relieve BPH symptoms. Some involve medicines that relax muscles in the bladder neck and reduce testosterone levels to shrink the prostate. Others involve devices that drain urine into a bag.
BPH treatment also includes minimally invasive surgery with tiny cuts and tube-style instruments that doctors insert into the urethra. These procedures may relieve symptoms as well as medicines and have less risk of complications.
For those who are unable to take or tolerate medicines, doctors can perform transurethral resection of the prostate (TURP). This involves cutting out a portion of the enlarged prostate. There are also other noninvasive surgical options that your doctor might recommend, such as a permanent implant called UroLift. This device lifts and holds the prostate tissue out of the way, so your urethra can flow freely.
Potential Side Effects of Latest Treatments
Enlarged prostates put pressure on the urethra, making it difficult to pee. New techniques like water vapor thermal therapy (WVTT) and prostate-specific membrane antigen-targeted radionuclide treatment with radium-223 (Xofigo) aim to reduce this pressure by shrinking the prostate gland. Both treatments have some urinary side effects, but they are usually temporary and mild.
Prostate cancer is often driven by male sex hormones, so androgen-deprivation therapy (ADT) lowers testosterone levels. This can be done surgically by removing the testicles or with medications, such as apalutamide, darolutamide, and enzalutamide. If ADT doesn’t control the cancer, cabazitaxel (Jevtana) is an option that adds to standard chemotherapy.
If the cancer has spread to bone, there is a risk of fractures, pain, and spinal cord compression. Bone-modifying drugs like denosumab and zoledronic acid, given once per month, can help reduce this risk.
Talk to your doctor about what is best for you. You can discuss your preferences and the benefits and risks of each treatment. This type of discussion is called shared decision-making and helps you make the most of your care. It can also give you the confidence to choose treatments that are right for you. You and your doctor can decide together whether you want to consider a clinical trial.
Conclusion
In 2023, advancements in medical research have paved the way for innovative treatments for an enlarged prostate, a condition that significantly affects the quality of life for many men. From minimally invasive surgeries to breakthrough medications, these treatments aim to alleviate symptoms and improve patients’ overall well-being. A key concern for many suffering from an enlarged prostate is how to stop frequent urination at night. With these latest treatments, patients now have more effective options to address this issue, allowing for a more restful night’s sleep and a better quality of life.
