Minimally Invasive Treatment Of Benign Prostate Hyperplasia -Urology Sorrento

Most cases of benign prostatic hyperplasia never require surgery and can be treated with self-care practices and medication. However, in more extreme cases, surgery may be necessary. When looking into operative procedures to reduce the size of an enlarged prostate, there are a number of minimally invasive procedures available.

Prostatic Stents

Prostatic stents are permanent devices inserted into the urethra to maintain the patency of the lumen. The stents provide improved urine flow comparable to that achieved with TURP and can be put in place on an outpatient basis in many cases. They have been reported to cause irritation during urination.

Laser Prostatectomy

As technology advances, the use of lasers of various types and wavelengths have become more commonplace. As a result, laser prostatectomy (removal of part of the prostate) has gained a higher degree of acceptance for treatment of BPH. Compared to traditional open prostatectomy, patients undergoing laser prostatectomy require a shorter period of hospitalization. In many cases patients can even be admitted on an outpatient basis.

There are four general techniques for performing laser prostatectomy. These include transurethral laser enuncleation, transurethral laser photoselective vaporation of the prostate (PVP), non-contact visual laser ablation of the prostate (VLAP) and interstitial laser coagulation of the prostate (ILC). Each of these procedures over their own unique advantages and drawbacks. Of the above, ILC is the least invasive and can most readily be performed on an outpatient basis. PVP is the only form of laser prostatectomy that seems to hold the potential of being as effective as the invasive transurethral resection of the prostate (TURP) procedure.

Transurethral (and Transrectal) Thermotherapy
Transurethral thermotherapy uses microwave energy to destroy prostate tissue. A probe is used to deliver microwave frequencies to the desired areas of the prostate while the surrounding areas are cooled via catheter. This procedure offers the benefit of being able to be performed on an outpatient bases. Because of the minimally invasive nature of the procedure, it is safer than TURP, but has been shown to be less effective.

Transurethral Electrovaporization

This procedure uses electrical current to vaporize and coagulate prostatic tissue. This procedure is beneficial in that it results in no bleeding or fluid absorption. Studies indicate that it approaches TURP in efficacy, while offering increased safety and fewer side effects. Transurethral electrovaporization generally requires hospitalization for only one day.

High Intensity Focused Ultrasound

In this procedure, ultrasonic energy is introduced transrectally to heat the prostate. Complications including bloody ejaculate and transient urinary retention have been reported postoperatively. This form of BPH treatment is still being investigated in the U.S.

Transurethral Needle Ablation (RF Therapy)

Transurethral needle ablation (TUNA) utilizes needles to introduce high-frequency radio waves to the prostate, thermally damaging the desired portions of prostatic tissue. Due to recent technological and procedural advances, the Prostiva RF treatment seems promising in its ability to match the effectiveness of TURP, while offering increased safety and decreased incidents of complication without hospitalization. Prostiva RF therapy can be performed on an outpatient basis by a urologist in an office setting in about an hour under local anesthetic.