As men get older, they are more likely to develop an enlarged prostate, also called benign prostatic hyperplasia (BPH). Lower urinary tract symptoms (LUTS), such as difficulty urinating and more frequent urination, are common in men with BPH. With BPH, prostate tissue grows inward, which puts pressure on the urethra (the tube from which urine and semen exit the body.)
There are several types of treatments for BPH/LUTS, including medication and surgery. Other types of treatments are considered minimally invasive.
Some of the more common minimally-invasive treatments include the following:
• Transurethral microwave thermotherapy (TUMT). This technique uses heat from microwaves to destroy excess prostate tissue. The microwaves are sent down the urethra through a catheter. A computer is used to control the microwaves and the amount of heat they emit. There is also a cooling system in place to protect the urinary tract from damage.
TUMT can usually be completed in an hour in an outpatient setting. Often, patients do not need any anesthesia.
• Transurethral needle ablation (TUNA). Like TUMT, this procedure also uses heat to destroy excess prostate tissue. However, the heat comes in the form of radio waves that are delivered through needles. Shields are used to protect the urinary tract. Generally, TUMT procedures last an hour or less and are done on an outpatient basis. Patients are given local anesthesia. Some men feel a burning sensation during the procedure.
• Water-induced thermotherapy. With this technique, the surgeon uses a special catheter that forms a balloon in the center of the prostate gland. Heated water is sent down the catheter to fill the balloon. Like TUMT and TUNA, the heat destroys tissue. The water temperature is regulated by a computer, so the urethra and bladder are protected.
• Visual laser ablation of the prostate (VLAP). This technique uses laser energy to destroy prostate tissue.
• Transurethral vaporization of the prostate (TUVP). With TUVP, laser energy vaporizes prostate tissue.
Stenting is another type of minimally-invasive procedure, but it does not involve removing prostate tissue. Instead, stents – small coils or springs made of plastic or metal – are inserted into the urethra to keep it open. Stenting requires local or spinal anesthesia and can be done in an outpatient setting. It is not common, however, and is usually reserved for men who are poor candidates for other BPH/LUTS treatments.
Men with BPH/LUTS are encouraged to discuss their treatment options with their urologist.