CancerCare Manitoba
 
 
 
Treatment Options

 

Treatment is usually offered based on how bad the symptoms are. Some men decide to live with their symptoms and not have treatment. Others opt for either medical or surgical treatment to alleviate symptoms.

Drug treatments

There are two types of drugs used to treat BPH:
  • Alpha-blockers relax the muscles of the prostate and bladder neck and improve urination. Men usually notice an improvement in their symptoms within a few days or weeks of starting treatment but these benefits last only when taking the medication. Side effects include fatigue, dizziness, nasal congestion and retrograde ejaculation (ejaculate does not come out of the penis with orgasm but rather flows into the bladder).
  • Five alpha-reductase inhibitors block testosterone and reduce the size of the prostate thereby decreasing pressure on the urethra. It may take several months to see reduction in symptoms and you have to continue to take these medications over the long term because if you stop, the prostate will just enlarge again. Side effects include loss of libido, erectile dysfunction and decrease in the amount of ejaculate.
  • A combination of these two treatments is highly effective but may result in an increased risk of side effects.

Surgical treatments

Another highly effective treatment of BPH is the surgical removal of prostate tissue where it is compressing the urethra. Transurethral resection of the prostate (TURP) is usually done by passing an instrument through the urethra and removing tissue from inside the prostate gland. Some urologists use a laser to remove the tissue. In some instances, the urologist needs to make an incision in the abdomen to gain access to the prostate gland; this is called an open prostatectomy.

Side effects of the surgery include retrograde ejaculation (semen passes into the bladder during orgasm instead of to the outside of the body). Some men may experience loss of erectile functioning after the procedure however this is rare.

Most men will experience a marked improvement in their urinary symptoms following this procedure however some will need a repeat of the surgery years later if symptoms recur.