How is bph different from prostate cancer




















An advantage of alpha blockers, compared to finasteride, is that they work almost immediately. They also have the additional benefit of treating hypertension when it is present in BPH patients. When the two drugs were compared in a study published in The New England Journal of Medicine , terazosin appeared to produce greater improvement of BPH symptoms and urinary flow rate than finasteride.

But this difference may have been due to the larger number of men in the study with small prostates, who would be more likely to have BPH symptoms from smooth muscle constriction rather than from physical obstruction by excess glandular tissue.

Doxazosin was evaluated in three clinical studies of men with BPH. Patients took either a placebo or 4 mg to 12 mg of doxazosin per day. Despite the previously held belief that doxazosin was only effective for mild or moderate BPH, patients with severe symptoms experienced the greatest improvement.

Among men treated for hypertension, the doses of anti-hypertension drugs may need to be adjusted due to the blood-pressure-lowering effects of an alpha-adrenergic blocker. Phosphodiesterase-5 inhibitors, such as Cialis, are commonly used for erectile dysfunction, but when used daily, they also can relax the smooth muscle of the prostate and overactivity of the bladder muscle.

Studies examining the impact of daily Cialis use compared to placebo demonstrated a reduction in International Prostate Symptom Score by four to five points, and Cialis was superior to placebo in reducing urinary frequency, urgency and urinary incontinence episodes. Surgical treatment of the prostate involves displacement or removal of the obstructing adenoma of the prostate. Surgical therapies have historically been reserved for men who failed medical therapy and those who developed urinary retention secondary to BPH, recurrent urinary tract infections, bladder stones or bleeding from the prostate.

However, a large number of men are poorly compliant with medical therapy due to side effects. Surgical therapy can be considered for these men to prevent long-term deterioration of bladder function.

Current surgical options include monopolar and bipolar transurethral resection of the prostate TURP , robotic simple prostatectomy retropubic, suprapubic and laparoscopic , transurethral incision of the prostate, bipolar transurethral vaporization of the prostate TUVP , photoselective vaporization of the prostate PVP , prostatic urethral lift PUL , thermal ablation using transurethral microwave therapy TUMT , water vapor thermal therapy, transurethral needle ablation TUNA of the prostate and enucleation using holmium HoLEP or thulium ThuLEP laser.

Thermal procedures alleviate symptoms by using convective heat transfer from a radiofrequency generator. Transurethral needle ablation TUNA of the prostate uses low-energy radio waves, delivered by tiny needles at the tip of a catheter, to heat prostatic tissue.

Retrograde ejaculation occurred in one patient. Another thermal treatment, transurethral microwave therapy TUMT , is a minimally invasive alternative to surgery for patients with bladder outflow obstruction caused by BPH. Performed on an outpatient basis under local anesthesia, TUMT damages prostatic tissue by microwave energy heat that is emitted from a urethral catheter. A new form of thermal therapy, called water vapor thermal therapy or Rezum, involves conversion of thermal energy into water vapor to cause cell death in the prostate.

With thermal therapies, several treatment sessions may be necessary, and most men need more treatment for BPH symptoms within five years after their initial thermal treatment. This procedure was first used in the U. Like transurethral resection of the prostate TURP , it is done with an instrument that is passed through the urethra.

But instead of removing excess tissue, the surgeon only makes one or two small cuts in the prostate with an electrical knife or laser, relieving pressure on the urethra. TUIP can only be done for men with smaller prostates. It takes less time than TURP, and it can be performed on an outpatient basis under local anesthesia in most cases. A lower incidence of retrograde ejaculation is one of its advantages.

In contrast to the other therapies that ablate or resect prostate tissue, the prostatic urethral lift procedure involves placing UroLift implants into the prostate under direct visualization to compress the prostate lobes and unobstruct the prostatic urethra. The implants are placed using a needle that passes through the prostate to deliver a small metallic tab anchoring it to the prostate capsule.

Once the capsular tab is placed, a suture connected to the capsular tab is tensioned and a second stainless steel tab is placed on the suture to lock it into place. The suture is severed. View a video of the UroLift procedure. It involves removal of the core of the prostate with a resectoscope — an instrument passed through the urethra into the bladder. A wire attached to the resectoscope removes prostate tissue and seals blood vessels with an electric current.

A catheter remains in place for one to three days, and a hospital stay of one or two days is generally required. TURP causes little or no pain, and full recovery can be expected by three weeks after surgery. In carefully selected cases patients with medical problems and smaller prostates , TURP may be possible as an outpatient procedure.

Improvement after surgery is greatest in those with the worst symptoms. The mortality from TURP is very low 0. Prostatectomy is a very common operation. About , of these procedures are carried out annually in the U. A prostatectomy for benign disease BPH involves removal of only the inner portion of the prostate simple prostatectomy.

This operation differs from a radical prostatectomy for cancer, in which all prostate tissue is removed. Simple prostatectomy offers the best and fastest chance to improve BPH symptoms, but it may not totally alleviate discomfort. For example, surgery may relieve the obstruction, but symptoms may persist due to bladder abnormalities.

While retrograde ejaculation carries no risk, it may cause infertility and anxiety. The frequency of these complications depends on the type of surgery. Surgery is delayed until any urinary tract infection is successfully treated and kidney function is stabilized if urinary retention has resulted in kidney damage.

Since the timing of prostate surgery is elective, men who may need a transfusion — primarily those with a very large prostate, who are more likely to experience significant blood loss — have the option of donating their own blood in advance, in case they need it during or after surgery. Infection is a risk. This treatment is best for men who are waiting for medication to work, or waiting for surgery. They also help when there is an infection, or for men toward the end of their lives, when surgery is not advised.

There are two types:. In severe cases of BPH, or when other options fail, more invasive surgery is recommended. More invasive surgery is best if you:. There are several types of more invasive surgery options from which to choose.

TUIP is used to widen the urethra if the prostate gland is small but causes a major blockage. For TUIP, the surgeon makes small cuts in the bladder neck, where the urethra joins the bladder and in the prostate. This widens the urethra and reduces the pressure of the prostate on the urethra, making urination easier. The hospital stay is one to three days. A catheter is left in your bladder for one to three days after surgery.

Some men need follow-up treatment. Men who do not want a complete prostatectomy removal of the prostate but need surgery are good candidates. PVP is a way to vaporize prostate tissue with a high-powered laser. Most men can have a PVP without problems. There are few side effects. After PVP, most men can stop medical therapy. This method is useful for most men except those with the largest of prostates.

Because this method causes very little blood loss it is particularly useful in men with a higher risk of bleeding, such as those taking blood-thinning medications or those with weak hearts. TURP uses electric current or laser light to cut and remove tissue. This is done with anesthesia and a tool called a resectoscope inserted through the penis.

The resectoscope provides light, irrigating fluid and an electrical loop. The loop cuts tissue and seals blood vessels. The removed tissue is flushed into the bladder and out of the body with a catheter.

In HoLEP, the surgeon places a thin, tube-like instrument a resectoscope through the penis into the urethra. A laser inserted into the resectoscope destroys the excess prostate tissue. No incisions cuts are needed and there is very little bleeding. You may only need to stay one night in the hospital. A catheter is used, but it is usually removed the next day.

Men with larger prostates who wish to avoid more-invasive surgery may be good candidates for this treatment. Men with a higher risk of bleeding, such as those taking blood-thinning medications, may also be good candidates for HoLEP. As in HoLEP, the surgeon places a resectoscope through the penis into the urethra.

No incisions cuts are needed. There is very little bleeding. A catheter may be used, but it is usually removed the next day. In TUVP, the surgeon inserts a resectoscope into the urethra with a lens, a light, and a tool that sends out an electrical current to destroy prostate tissue.

Heat from the electrical current seals small blood vessels, reducing the risk of bleeding. There is little bleeding or fluid absorption. You may stay one night in the hospital and you can usually return home without a catheter. Men with larger prostates who wish to avoid more-invasive surgery may be good candidates for TUVP. TWJA uses high-pressure water jets to destroy excess prostate tissue. The surgeon first uses ultrasound to precisely map the location of the excess tissue.

Then the high-pressure water jets are directed to that area. Following this, the surgeon inserts another instrument to seal small blood vessels to reduce the risk of bleeding. The patient needs to stay in the hospital one night to irrigate the bladder to prevent blood clots.

You may need to use a catheter for about 48 hours after the procedure and should be able to go home the next day. Simple prostatectomy removes the entire prostate gland with laparoscopic or robotic-assisted surgery.

It is important for the surgeon to be skilled at this surgery. This is only offered to men with the largest of prostate glands and is usually done using a robotic. This is a long-term cure. You will probably stay in the hospital for a few days after surgery and your activities will be limited for several weeks.

A catheter will usually be needed for 1 to 2 weeks while you heal. For most men, symptoms of BPH improve after treatment. Infection, bleeding, incontinence, and erectile dysfunction may occur after some treatments. In some cases, scar tissue may form. After surgery, it can take time for sexual function to return fully. Most experts believe that if you were able to have an erection shortly before surgery, you will be able to after surgery. Your orgasm is not expected to change.

In some cases, men can experience an issue where semen enters the bladder rather than out the penis retrograde ejaculation. Infection, bleeding and incontinence may occur after some treatments. Side effects vary with the type of treatment you choose and most side effects are temporary. Some men need further or new treatment for their BPH symptoms after initial treatment.

Once you have been treated with surgery for BPH, taking medicine may sometimes be needed to control residual or new symptoms. Sometimes men need repeated treatment to get rid of bothersome symptoms. This web site has been optimized for user experience and security, therefore Internet Explorer IE is not a recommended browser. Thank you. Diagram of Normal and Enlarged Prostate Enlarge.

Diagram of the Male Reproductive System Enlarge. Other symptoms include: Incomplete emptying: the feeling your bladder is full, even after passing urine. Frequency: the need to pass urine often, about every one to two hours.

Intermittency: the need to stop and start several times when passing urine. Weak stream: a weak urine flow. Straining: trouble starting to pass urine or the need to push or strain to pass urine. Nocturia: the need to wake up at night more than two times to pass urine.

Who is at Risk for BPH? There are many risk factors for BPH. There are many tests for BPH. The following tests are used to diagnose and track BPH. Take the test and talk with your doctor about your results. Prescription Drugs. Less Invasive Surgery. Symptoms of both are often similar. Pain in the hips and back is often a result of cancer spreading or pushing on the spinal cord. This is typically not experienced in patients who have BPH.

With BPH, the growing prostate narrows the urethra, leads to hypertrophy of the bladder and impedes the proper flow of urine, which is why BPH primarily has urination-focused symptoms.

Some patients also have a hard prostate. This is an indicator you have a nodule or tumor. Nodules and tumors can be both benign and malignant, so having a hard prostate may be an indicator of cancer, but it can also be prostate stones. Prostate stones develop around or in the prostate gland and are caused by blockages due to chronic inflammation or BPH.

The stones are not cancerous. The bottom line is if you are experiencing symptoms, there are several conditions this may point to. It is best to see a urologist who can help determine the cause of the symptoms and how best to treat it.

Contact the specialists at Advanced Urology to schedule an appointment today. We are committed to providing compassionate and extraordinary care by acting with attention, joy and authenticity. We aim to lead the way by way of innovation, excellence and the drive to change and make a lasting difference.

Patient experience is our top priority. We show this by operating with integrity, listening, and building trust with our patients and one another. Previous Next. View Larger Image. Different Symptoms of BPH vs.



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