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Enlarged Prostate Treatment Better with Surgery Compared to Drugs

Kathleen Blanchard's picture

Findings from a large study show that men who undergo surgery for enlarged prostate gland fare better than those treated with drugs. Treatment of enlarged prostate was compared to medication treatment in a large study. Compared to drugs, enlarged prostate treatment is better with surgery compared to taking medications to reduce symptoms.

Enlarged prostate gland, known as benign prostatic hypertrophy (BPH), occurs in fifty percent of men by age 60. According to the NIH, 90 percent of men in their seventies and eighties have symptoms of BPH. When the prostate gland becomes large, the result is urinary incontinence, susceptibility to urinary tract infections, leakage, and frequent need to urinate. Researchers from the Mayo Clinic studied 2184 healthy men with symptoms of BPH 1990 through 2007, finding that surgery is the best option for treating an enlarged prostate gland compared to taking medications to relieve symptoms.

The prostate gland normally grows with age. Researchers know little about the cause, and some men with very large prostate glands may not experience symptoms until urine flow becomes completely blocked. In other cases the prostate gland that lies in front of the rectum and below the bladder can obstruct the flow of urine leading to incomplete bladder emptying, frequent urination at night, weak urine stream, and feelings of incomplete bladder emptying. For men with symptoms of BPH, researchers found that the best treatment for reducing urinary incontinence is a surgical procedure known as a transurethral resection of the prostate (TURP). Medications can prevent symptoms from progressing.

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Another type of surgical treatment for an enlarged prostate is laser vaporization surgery. The researchers found the surgery provided no help for men suffering urinary incontinence, a symptom the researchers found was common among the men studied with enlarged prostate. Medication therapy using alpha adrenergic receptor blockers and 5-alpha-reductase inhibitors (ARIs) prevented symptoms from getting worse. TURP lowered urinary incontinence in men with enlarged prostate from 64.5 percent to 41.9 percent.

BPH is a common occurrence with aging. Enlarged prostate may or may not cause symptoms for men. When the prostate gland becomes larger, something that is normal with age, the cells can grow into the bladder and block urine flow. When the bladder becomes full leakage and urinary incontinence ensue. The cause, though not completely understood, is likely due to hormonal changes from testosterone derivatives that cause prostate gland cells to spread.

The study should make it easier for men to choose treatment options for enlarged prostate. Compared to medication therapy, surgery was found to be a better option for reducing symptoms of urinary incontinence for men suffering from BPH. Laser vaporization surgery also compared more favorably for helping men suffering from symptoms of enlarged prostate than taking medications, but did not reduce urinary incontinence. Men taking medications for enlarged prostate reported an increase in symptoms of urinary incontinence. The study is the first to collect data about outcomes for treatment of enlarged prostate, showing that TURP surgery offers significant help for reducing urinary incontinence.

Mayo Clinic