BENIGN PROSTATIC HYPERTROPHY: This is a benign condition in which the prostate gland has increased in size, and is creating a mechanical condition that obstructs the outflow of urine. Major advancements have been made in the medical and surgical treatment of this disease. Medical Therapy: For patient with moderate symptoms and not in retention requiring catheterization, ?-blockers and 5-reductase inhibitors are the mainstay of therapy. However, this commits the patient to long term medications, with some side effects of sexual dysfunction. Many patients are very happy and content on these medications. Not all patients can tolerate the side effects of the medications. Minimally Invasive Surgical Therapy: There are 2 office-based therapies that work very well for BPH, Microwave and Needle Ablation. Both of these procedures are covered by insurance. Transurethral Microwave Therapy (TUMT): This procedure takes about an hour in the office with only a local nerve block. A catheter with a microwave antennae built in, is used to "cook" the prostate. Transurethral Needle Ablation (TUNA) This procedure is also done in the office and takes about an hour, and uses a local nerve block. A cystoscope with needle-like fangs is introduced into the prostate, and tissue is again "cooked." Cryosurgery: This procedure is best for larger glands that cannot be treated as well with TUMT or TUNA. It is done as an outpatient at Alhambra Medical Center and requires general anesthesia. Cryosurgery can treat much larger areas of tissue vs. TUMT and TUNA. Cryosurgery can treat very large glands. This procedure is not generally covered by insurance. HIFU HIFU can treat moderately large to smaller glands. Again much more tissue can be treated than with TUMT or TUNA. However, for really large glands, HIFU is not ideal, and cryosurgery is better. HIFU is done as outpatient surgery, and spinal anesthesia is required. Currently, HIFU can only be done in Mexico. Laser Surgery: We have been experienced in the use of lasers since 1985. However, candidates for lasers for BPH are the same as for TUNA/TUMT. It requires hospitalization and general anesthesia. We therefore utilize this procedure less often.
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