The Pros and Cons of Minimally Invasive Surgery for BPH

What is Benign Prostatic Hyperplasia?

BPH, or benign prostatic hyperplasia, is a non-cancerous enlargement of the prostate gland that commonly affects older men. The prostate gland is a walnut-sized gland located below the bladder and surrounds the urethra, the tube that carries urine from the bladder out of the body.

As the prostate gland grows larger, it can put pressure on the urethra, causing a variety of urinary symptoms such as difficulty starting urination, weak urine flow, frequent urination, and the need to urinate urgently. In severe cases, BPH can lead to bladder and kidney problems if left untreated.

Surgical intervention may be necessary for BPH when medications and lifestyle changes do not provide adequate relief of urinary symptoms, or if complications such as bladder stones, urinary retention, or kidney damage occur.

Is Surgery Necessary for BPH?

Surgical procedures for BPH aim to remove or reduce the size of the prostate gland, thus relieving the pressure on the urethra and improving urinary symptoms. There are a variety of surgical options available, including minimally invasive procedures such as transurethral resection of the prostate (TURP), transurethral microwave thermotherapy (TUMT), and prostate artery embolization (PAE), as well as traditional open surgery.

Whether treatment via surgery is the right option for you will depend on a number of factors, such as the size of the prostate, the severity of symptoms, and your overall health. In some cases you can manage your BPH by making lifestyle changes or with medication. If your symptoms are more severe, it is likely that your GP or urologist (or other specialist) by recommend surgical intervention.

What Are The Types Of Minimally Invasive Treatments for An Enlarged Prostate?

When it comes to treating BPH with surgery, TURP has long been considered the gold standard. However, advancements in a number of minimally-invasive procedures are providing men with other options, most of which have a number of advantages over TURP, which can be considered a major surgery.

These are just some of the options available to you, should you be interested in a minimally invasive treatment:

• Transurethral Needle Ablation (TUNA): This technique shrinks the prostate gland by heating and destroying extra prostate tissue with radiofrequency energy. A local anaesthetic is typically used during TUNA procedures, and problems are rare.
  
  
• Transurethral Microwave Thermotherapy (TUMT): This method involves heating and destroying extra prostate tissue with microwave energy. In contrast to TURP, TUMT is frequently performed as an outpatient procedure, and the recovery period is shorter.
  
  
• Prostate Artery Embolization (PAE): This non-surgical method involves cutting off the prostate gland's blood supply, which causes the prostate tissue to contract. When compared to standard surgery, PAE has a lower risk of complications and is often performed by an interventional radiologist, and is our preferred treatment option for BPH.
  
  
• Laser-based surgery: Many laser-based surgical treatments, including holmium laser enucleation of the prostate (HoLEP) and photoselective vaporisation of the prostate, are available for the treatment of BPH (PVP). In comparison to TURP, these treatments use laser energy to remove extra prostate tissue, and they are linked to shorter hospital stays and quicker recovery times.

What Are The Advantages of Minimally-Invasive BPH Treatments?

Minimally invasive treatments for BPH (benign prostatic hyperplasia) offer several benefits compared to traditional open surgery. Some of these benefits include:

1. Less pain: Minimally invasive procedures for BPH typically involve smaller incisions and less tissue damage, leading to less pain and discomfort for patients.
   
   
2. Shorter hospital stay: Many minimally invasive procedures for BPH can be performed on an outpatient basis or require only a short hospital stay, compared to several days of hospitalization required for traditional open surgery.
   
   
3. Faster recovery: Minimally invasive procedures for BPH often have a shorter recovery time compared to traditional open surgery. Patients can usually resume their normal activities within a few days to weeks after the procedure.
   
   
4. Lower risk of complications: Minimally invasive procedures for BPH have a lower risk of complications compared to traditional open surgery, such as bleeding, infection, and incontinence.
   
   
5. Better cosmetic results: Minimally invasive procedures for BPH usually leave smaller scars or no scars at all, leading to better cosmetic results.
   
   
6. Improved urinary symptoms: Minimally invasive procedures for BPH are highly effective in improving urinary symptoms associated with an enlarged prostate, such as weak urine flow, frequent urination, and the need to urinate urgently.

Overall, minimally invasive treatments for BPH offer a safer and more effective alternative to traditional open surgery. Patients who undergo minimally invasive procedures can expect less pain, shorter hospital stays, faster recovery, and better cosmetic results, as well as a significant improvement in their urinary symptoms.

What Are The Disadvantages of Minimally Invasive BPH Treatments?

While there are many benefits to minimally invasive treatments for BPH (benign prostatic hyperplasia), there are also some potential disadvantages to consider. These include:

1. Not suitable for all patients: Minimally invasive treatments may not be suitable for all patients with BPH, particularly those with very large prostates or severe symptoms. In these cases, traditional open surgery may be the best option.
   
   
2. Potential for incomplete removal of prostate tissue: Some minimally invasive procedures may not be able to remove all of the excess prostate tissue, which can lead to a higher chance of needing additional treatment in the future.
   
   
3. Risk of complications: While minimally invasive procedures have a lower risk of complications compared to traditional open surgery, there is still a risk of complications such as bleeding, infection, and urinary incontinence.
   
   
4. Limited long-term data: While minimally invasive procedures for BPH have shown good short-term results, there is limited long-term data on their effectiveness and durability.
   
   
5. Cost: Minimally invasive procedures for BPH can be more expensive than traditional open surgery, and not all insurance plans may cover the cost.

It's important to note that the potential disadvantages of minimally invasive treatments for BPH are relatively rare and may not apply to all patients. The choice of treatment should be based on a thorough discussion with your healthcare provider, taking into consideration your individual health status and treatment goals.

The Importance of Discussing Your Options 

In order to choose the best course of therapy for their unique needs, people with BPH (benign prostatic hyperplasia) must speak with their doctor. Although minimally invasive BPH treatments have numerous advantages, they might not be the ideal choice for everyone. The best course of action must be decided after a thorough analysis of each patient's health, prostate size, and urinary symptoms.

Patients who seek the advice of a healthcare professional are also better able to weigh the advantages and disadvantages of various treatment options and make wise choices regarding their care. Healthcare professionals can assist patients in weighing the benefits and drawbacks of each treatment choice while taking into account the patient's age, general health status, and way of life.

Furthermore, healthcare professionals can advise patients about the various minimally invasive procedures that are available and assist them in selecting the one that is most appropriate for their particular circumstances. For instance, some minimally invasive techniques might be more appropriate for people with smaller prostates while others might be more successful for those with larger prostates.

In general, receiving individualised and efficient treatment for BPH patients requires consultation with a healthcare professional. If you are ready to discuss your treatment options for BPH, book a consultation with Northern Beaches Interventional Radiology today.