Medications, laser treatment and surgery can all arrest the growth of an enlarged prostate gland, but only surgery can produce an improvement in symptoms, particularly a reduction in incontinence, researchers say.
The procedure, transurethral resection of the prostate, or TURP, is generally reserved for those who have failed to respond to drug treatment or who cannot tolerate the medications. However, new findings suggest it might be useful to introduce this approach earlier in the course of the disease, said Dr. Amy Krambeck of the Mayo Clinic, who reported the findings at a meeting of the American Urological Association.
More than half of men older than 50, and more than 80 percent of men older than 90 suffer from benign prostatic hyperplasia, or BPH. The most common symptoms include a frequent urge to urinate and persistent leakage. Multiple treatments are available, but data comparing medications with surgery are very limited. For patients with the mildest symptoms, treatment may entail little more than reducing consumption of alcohol and caffeine.
Among those who received treatment, the best improvement in symptoms was seen in the TURP group, followed by laser vaporization, then drugs. Only the surgical intervention group reported a decrease in incontinence. Regardless of whether medication or surgery was used, the symptoms appeared to stabilize. Counterbalancing the effectiveness of the surgery, however, are the potential side effects, including bleeding, low sodium in the blood, incontinence and erectile dysfunction.