Last updated: 11/24/2009

Conventional surgical alternatives for BPH patients include:

• Interstitial laser coagulation. In this procedure, a laser beam inserted in the urethra via a catheter heats and destroys the extra prostate capsule tissue.
• Transurethral...
  
  needle ablation (TUNA). This technique was approved by the FDA in 1996. It uses radio waves to heat and destroy the enlarged prostate through needles positioned in the gland. It is generally less effective than TURP for reducing symptoms and increasing urine flow.
• Transurethral electrovaporization. This procedure is a modified version of TURP, and uses a device that produces electronic waves to vaporize the enlarged prostate.
• Photoselective vaporization of the prostate (PVP). This procedure uses a strong laser beam to vaporize the tissue in a 20–50 minute outpatient operation.
• Transurethral incision of the prostate (TUIP). In this procedure, a small incision is made in the bladder, followed by a few cuts into the sphincter muscle to release some of the tension.
• Transurethral microwave thermotherapy (TUMT). TUMT uses microwave heat energy to shrink the enlarged prostate through a probe inserted into the penis to the level of the prostate. This outpatient procedure takes about one hour. The patient can go home the same day, and is able to resume normal activities within a day or two. TUMT does not lead to immediate improvement, and it usually takes up to four weeks for urinary problems to completely resolve.
• Water-induced thermotherapy (WIT). WIT is administered via a closed-loop catheter system, through which heated water is maintained at a constant temperature. WIT is usually performed using only a local anesthetic gel to anesthetize the penis, and is very well tolerated. The procedure is FDA approved.
• Balloon dilation. In this procedure, a balloon is inserted in the urethra up to where the restriction occurs. At that point, the balloon expands to push out the prostate tissue and widen the urinary path. Improvements with this technique may only last a few years.

BPH patients have experienced improved prostate health from the following:

• Zinc supplements. This mineral plays an important role in prostate health because it decreases prolactin secretion and protects against heavy metals such as cadmium. Both prolactin and cadmium have been associated with BPH.
• Saw palmetto. Saw palmetto has long been used by Native Americans to treat urinary tract disturbances without causing impotence. It shows no significant side effects. A number of recent European clinical studies have also shown that fat soluble extracts of the berry help increase urinary flow and relieve other urinary problems resulting from BPH.
• Garlic. Garlic is believed to contribute to overall body and prostate health.
• Pumpkin seed oil. This oil contains high levels of zinc and has been shown to help most prostate disorders. Eating raw pumpkin seeds each day has long been a folk remedy for urinary problems, but German health authorities have recently recognized pumpkin seeds as a legitimate BPH treatment.
• Pygeum bark. The bark of the Pygeum africanus tree has been used in Europe since early times in the treatment of urinary problems. In France, 81% of BPH prescriptions are for Pygeum bark extract.

Recent developments in BPH treatment options include:

• The Urologix Targis ^TM System. This is a microwave device that uses the same heating method as TUMT. The procedure takes about an hour, and requires no anesthesia. The urologist inserts a flexible tube into the penis. This tube contains a unique microwave antenna that is able to generate very localized hot spots while cooling the surrounding areas. Diseased prostate tissue is destroyed with very little discomfort and a short recovery time. To date, men who have had this procedure have yet to develop impotence or incontinence.
• The Dornier MedTech Urowave. This device is another proprietary microwave heating device, similar to the Targis System.
• Transurethral alcohol treatment. This recent development is very promising for the treatment of BPH. The procedure involves injecting ethyl alcohol into the lateral and middle lobes of the prostate. The alcohol kills prostate tissue, which the body then absorbs. Early results are encouraging, and show that all patients (who were originally scheduled for TURP) were able to urinate freely after 24 hours. More studies are required to assess long-term outcomes.
• Prostatic stents. Stents are wire devices shaped like small springs or coils. They are placed within the prostate channel to maintain its patency (keep it open). These devices are currently under investigation and are not yet FDA-approved.
• Aromatase. This inhibitor drug suppresses excess levels of estrogen in the blood. In many men, estrogen is the primary growth-stimulating agent that causes prostatic overgrowth.