BPH Treatment Options

BPH Treatment Options


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Now that you’ve learned about BPH, you can empower yourself by learning more about your treatment options. Typical treatment options fall into four categories: Watchful Waiting, medications, minimally invasive treatments and traditional surgery.

Let’s briefly discuss each option to help you understand and evaluate them. Your doctor can help you determine which option is best for you.


Treatment Options:

  • Watchful Waiting: Watchful Waiting involves making behavioral changes such as decreasing your fluid intake prior to bedtime, regular physical activity, and avoiding caffeine and alcohol. For men with mild symptoms this may be a viable option until their condition shows signs of worsening. However, it is important to note that, in a study, 87% of men who elected Watchful Waiting experienced a worsening of symptoms over a 4-year time period.2
  • Medications: Your doctor may prescribe one BPH medication or a combination of BPH medications that may help alleviate your urinary symptoms. Sometimes the medications are effective and improve BPH symptoms; however, some men experience little relief. In addition, some men experience bothersome side effects from BPH medication. Many men tend to ultimately discontinue the medication.3-6
  • Minimally Invasive Treatments: These are procedures which can often be done as an outpatient procedure with milder forms of anesthesia. They typically have fewer complications than traditional surgery.7

    The UroLift® System is one of the leading minimally invasive BPH procedures. It uses small implants to open the prostate blockage and does not require heating or cutting tissue. The procedure is typically performed under local anesthesia in a doctor’s office and patients typically return home the same day without a catheter. The UroLift System offers rapid symptom relief with a low risk profile. As the procedure does not destroy tissue, recovery is typically quicker than other procedures. It is the only leading BPH procedure shown to provide symptom relief while also preserving sexual function.*8-11


    * No instances of new, sustained erectile or ejaculatory dysfunction in the L.I.F.T. pivotal study.


    Another minimally invasive BPH treatment is Rezum™ Water Vapor Therapy., This is a form of thermal therapy in which the prostate is heated with steam. Another form of thermal therapy called Transurethral Microwave Therapy (TUMT) uses microwaves to destroy tissue.7 They can typically be done at a doctor’s office with local or light anesthesia and patients can usually go home the same day as the procedure. These procedures generally have fewer complications than traditional surgery. A catheter is typically required for a few days after the procedure and recovery may take a few weeks.11-13

  • Traditional Surgery: Common traditional BPH surgeries include transurethral resection of the prostate (TURP) and laser photoselective vaporization of the prostate (Greenlight laser PVP).14-15 These procedures are the most aggressive treatment option and can be effective. Recovery can take time and is accompanied by a higher risk of complications. Less commonly performed surgeries include Aquablation and Holmium Laser Enucleation of the Prostate (HoLEP).3,7 Aquablation uses a high-pressure water jet to remove prostate tissue, whereas HoLEP uses a laser to remove the prostate tissue. Surgery can offer significant relief of symptoms and help you improve quality of life.1

Comparing Treatment Options:

If you are looking to move on from Watchful Waiting, it is important to understand how the different treatment options compare to each other. Depending on your treatment goals, some of these options may be a better choice for you. Here is a comparison of some of the treatment options based on the most common goals of BPH patients.


Note: Data in the above table come from head-to-head studies between individual therapies as well as meta-analysis across multiple studies. Some studies were sponsored by Teleflex Incorporated, manufacturer of the UroLift® System. A comprehensive head-to-head study comparing all of the above therapies has not been conducted at this time.


a. Recovery is defined as return to normal daily activities with little or no interference (Tutrone, Can J Urol 2020). TURP/Laser not studied with this definition of recovery.
b. Based on patients who underwent a voiding trial.
c. Excludes patients with obstructive median lobes for the UroLift® System, who are estimated to account for ~5% of the eligible UroLift System population.
d. Includes severe bleeding only (clinically defined as Clavien-Dindo grade IIIb)
e. Patients treated with the post-FDA clearance technique requiring a procedure to specifically remove an implant. This was studied in a clinical trial with >1,400 patients.
f. Urinary leakage due to sudden pressure on the bladder from activities such as exercise, laughing, coughing, sneezing etc. (clinically known as stress urinary incontinence)
g. UroLift System definition of erectile and ejaculatory dysfunction requires new onset and sustained event. Other therapies described have different definitions of sexual preservation.

The BPH Advisor™ provides further information on the different types of treatment methods.


If you’re looking for an alternative to medications or traditional surgery, the minimally invasive UroLift® System may be an option for you. Click here to learn more: https://www.urolift.com/what-is-urolift.

As with any medical procedure, individual results may vary. Speak with your urologist to see if the UroLift System treatment is right for you. Most common side effects are temporary and include painful urination, blood in the urine, pelvic pain, urinary urgency and/or the inability to control the urge. Rare side effects, including bleeding and infection, may lead to serious outcomes and may require intervention. Most symptoms typically resolve within two to four weeks after the procedure.6


References
1 AUA BPH Guidelines 2003. Updated 2010.
2 McConnell, N Engl J med 2003;349:2387-98
3 Chang DF, Campbell JR, J Cataract Refract Surg. 2005 Apr; 31(4): 664-673
4 Duan et al, Pharmacoepidemiol Drug Saf. 2018 Mar; 27(3): 340-348
5 Welk et al, JAMA Intern Med. 2017 May 1; 177(5): 683-691
6 Roehrborn, J Urol 2013; 190(6): 2161-7
7 Roehrborn, Can J Urol 2017; 24(3): 8802-8813
8 Shore Can J Urol 2014
9 Tutrone, Can J Urol 2020
10 Eure, et al., AUA 2020
11 Sonksen, et al., Eur Urol 2015 Oct; 68(4): 643-52
12 McVary, J Urol 2016; 195(5):1529-1538
13 McVary, J Urol 2020; 203(4S): AUA abstract LBA01-06 5-year Rezum
14 Mollengarden, et al., Prostate Cancer Prostatic Dis 2018 Sep; 21(3): 379-385
15 Babar, NSAUA 2019
16 Bachmann, et al., Eur Urol 2014; 65(5): 931-942
17 Strope, Urology 2015; 86: 1115-1122
18 Rassweiler, et al., Eur Urol 2006; 50(5): 969-980

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BPH Advisor™

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