Benign Prostatic Hyperplasia (BPH) is the most common prostate disease. It consists in the growth of a part of the organ, specifically the one that allows the passage of urine from the bladder to the outside. Due to this increase in size, the urinary duct is narrowed, which complicates urination.
It is a disease present in more than half of men over 60 years of age and in 80% of the elderly. It has nothing to do with prostate cancer, but both diseases can coexist in the same patient.
The prostate begins to grow gradually in all men from the age of 30 and, in this sense, a considerable increase can lead to Benign Prostatic Hyperplasia. Such enlargement may be aggravated by aging.
Symptoms of BPH
Symptoms range from obstructive symptoms, such as sluggish voiding stream, sensation of incomplete voiding, postvoid dribbling, increased voiding frequency during the day and during sleep hours, to other symptoms such as urgency to urinate and even urinary incontinence.
These symptoms worsen as the gland grows. Although it is a benign pathology, it can lead to medical complications such as acute urinary retention, bladder catheterization, prostatic bleeding, bladder lithiasis (presence of stones) or renal failure.
What is the most appropriate treatment?
It is estimated that one third of patients suffering from BPH end up requiring surgical treatment, due to poor response to drugs or due to complications of the disease itself.
On the surgical side, several years ago open adenotomy was used, which consists of opening the abdomen to remove the benign tumor completely. This technique was extremely aggressive, especially for older people. For this reason, minimally invasive methods have been used almost exclusively for some time now.
The most appropriate surgical technique depends on the size of the prostate and its characteristics. Dr. Alonso y Gregorio takes a comprehensive approach to the different alternatives and offers his patients the best one for each specific case.
The techniques that offer the best results are Holmium laser and green laser photovaporization.
These alternatives are ideal if the aim is to avoid the side effects of conventional methods. All drugs used for the treatment of Benign Prostatic Hyperplasia produce retroejaculation.
In addition, the prostate is an organ that, when operated on, bleeds somewhat more abundantly, so that with these techniques, this bleeding is avoided.
- The Holmium laser
It is especially indicated for large prostates. Its main advantage is the absence of incisions, minimal risk of bleeding and rapid discharge without the need for a catheter.
- Green laser photovaporization
It is especially indicated for small prostates and offers the same advantages as the Holmium laser. It is a minimally invasive treatment, which consists of evaporating the tissue obstructing the urinary duct by means of laser. Once the operation has been performed, the patient remains in the hospital for less than 24 hours, leaves the hospital without a catheter and can resume routine activities in 2 or 3 days. It is considered one of the most important advances that has been made in the last 25 years in the surgical treatment of Benign Prostatic Hyperplasia.
- The Rezum® System
It has been a true revolution in the surgical treatment of Benign Prostatic Hyperplasia. The intervention is minimally invasive, is performed in less than five minutes, general anesthesia is not necessary (although it is recommended) and the side effects affecting the sexual sphere are reduced to zero. It consists of the introduction through the urethra of a device that releases hot water vapor. Once the prostate gland is reached, the device expels the steam, which destroys the excess prostate tissue that obstructs the flow of urine. After the operation, the patient can go home with a temporary catheter.
- Enucleation by laparoscopy
This is an excellent alternative to the Holmium laser, although it tends to be the least common. The main objective of the operation for BPH is to improve the quality of life of our patients.