What Is the Best Treatment for Enlarged Prostate? We Compare

Highlights

• The best treatment for enlarged prostate varies according to each case, making medical consultations essential.
• A range of surgical and non-invasive treatments is available for treating enlarged prostates, including Urolift, Rezum, and HoLEP.
• Medications such as Cialis can significantly improve enlarged prostate symptoms and reduce LUTS and ED, including after surgery takes place.

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Benign prostatic hyperplasia (BPH) is a common condition among aging men. Its prevalence increases with age, with 50 to 60% of men experiencing it in their sixties and up to 90% in their seventies. As an uncomfortable condition, it can produce lower urinary tract symptoms (LUTS) and may result in erectile dysfunction (ED).

What’s the Best Treatment for Enlarged Prostate?

BPH treatment has evolved in recent years and ranges from watchful waiting (no clinical intervention) to surgical interventions. However, the best treatment for you will be based on your individual symptoms and medical history. It’s a decision you’ll want to make with help from your doctor. 

Here are the treatment options your doctor will likely go over with you.

Watchful Waiting

The term “watchful waiting” almost appears to imply doing nothing. In reality, it involves making a series of lifestyle changes that may reduce BPH symptoms.

Watchful waiting is generally used only for mild to moderate cases. It involves holding back on medical and surgical interventions while monitoring the effects of lifestyle adjustments. Doctors may recommend weight loss, reducing caffeine intake, and avoiding certain over-the-counter medications during this period. They’re likely to request regular reviews of the progression of your symptoms. 

Around 31% of men who try watchful waiting experience disease progression within four years. As BPH is an age-related condition, this isn’t surprising. However, that doesn’t mean using this approach in the short term is without its merits.

When and How Watchful Waiting Proves Useful

Watchful waiting may be the best treatment for early-stage BPH. It isn’t risk-free, but it does come with certain benefits.

The potential benefits of watchful waiting include:

• Lower costs
• Fewer side effects
• Avoiding surgery
• Improved overall health due to lifestyle changes

Risks of trying watchful waiting may include:

• Worsening symptoms
• Increase in LUTS
• Irreversible symptoms

Surgery

The types of surgery used for treating BPH have evolved significantly. They’re less invasive yet produce desirable results. Many are available as outpatient procedures, which avoids lengthy hospital stays.

Transurethral Resection of the Prostate (TURP)

TURP has long been considered the best surgical treatment for enlarged prostate. However, while it can produce excellent results, more modern approaches with fewer side effects may be replacing it as the gold standard in BPH care. 

TURP involves inserting a rectoscope — a small device with a camera, light, and wire loop — into the urethra. Surgeons use the rectoscope to cut away sections of the prostate gland, then flush away the prostate pieces. Shrinking the prostate reduces symptoms such as painful or frequent urination.

Benefits of TURP include:

• Easier urination
• Reduced urinary retention
• Permanent reduction of symptoms

However, TURP also carries risks, including:

• Retrograde ejaculation, or “dry orgasms”
• Reduced fertility
• Urge incontinence
• Narrow urethra
• Erectile dysfunction

Holmium Laser Enucleation of the Prostate (HoLEP)

At first, HoLEP sounds similar to TURP. The surgeon’s approach involves using a small device to laser away fragments of the enlarged prostate that’s causing LUTS. Unlike TURP, HoLEP is an option when the prostate is severely enlarged and may help avoid more-invasive procedures.

Overall, HoLEP has a lower repeat surgery rate than TURP.  Around 4.5% of those who undergo TURP need retreatment versus 1.27% for HoLEP. Overall, five-year outcomes for both surgeries are roughly the same, but HoLEP carries fewer side effects.

Benefits of using HoLEP include:

• Shorter surgery time
• Reduced ED risk
• More tissue removal
• Less blood loss
• Reduced catheter time

Risks of HoLEP include:

• Postoperative UTI
• Blood in urine
• Anesthesia reaction
• Bladder infection

Urolift

Compared to TURP and HoLEP, Urolift takes a novel approach. Its aim isn’t to destroy tissue. Instead, it compresses the area of the prostate that’s pressing on the bladder and urethra so that symptoms reduce.

Urolift isn’t a viable treatment for everyone, though. It’s suitable for cases where the prostate is medium-sized but less so when the prostate is severely enlarged. 

Its benefits include:

• Preserved sexual function
• Fast recovery
• Local anesthesia only
• No heating or cutting

As with all surgeries, Urolift comes with short-term risks that last a few weeks:

• Painful urination
• Blood in the urine
• Lower abdominal pain

Rezum

Rezum differs from both HoLEP and Urolift in the sense that it uses steam to remove enlarged areas of the prostate. Using a handheld device, the surgeon targets enlarged areas of the prostate with steam to destroy problematic tissue. At the same time, cooling saline is flushed through the urethra to protect it.

Rezum is a relatively new approach that’s primarily used for men with early BPH symptoms. However, preliminary studies show that it may also be used in men with moderate to severe progression. Its use can depend on the surgeon’s discretion and skill level.

Benefits of Rezum include:

• Symptom improvement
• Sexual function preservation
• Rapid procedure time
• No general anesthetic needed

Some reported risks include:

• Pelvic pain
• Urinary tract infection
• Epididymis inflammation
• Painful ejaculation

Medication

Watchful waiting and surgery aren’t always the best treatments for enlarged prostate. The phosphodiesterase-5 inhibitor Cialis offers a way to manage BPH symptoms without surgical intervention. When watchful waiting is no longer an option, taking Cialis or its generic tadalafil is a proactive way to tackle BPH and may help to avoid surgery.

Cialis and BPH

The prostate is a combination of connective and glandular tissues. Those connective tissues include muscles, which contract and restrict in the same way any muscle does. As the prostate enlarges, the muscle holds more tension.

Cialis relaxes prostate and bladder muscles while also increasing blood flow to the penis. When prostate muscles relax, they relieve pressure on the urethra. This reduces some LUTS symptoms, including poor urinary flow and intermittent flow. A relaxed bladder can also make passing urine easier.

As Cialis increases blood flow to the penis, it may also improve sexual function. If your sexual function is reduced due to an enlarged prostate, this can improve your quality of life. Around 40% of men aged 45 and over experience an improvement in LUTS and ED symptoms when taking Cialis.

Cialis/tadalafil can also prove useful after surgery. As some surgeries increase the risk of ED, using Cialis may help to improve postoperative sexual function.

Cialis isn’t the best BPH treatment for everyone, though. It’s not always compatible with blood pressure medications, so talk to your doctor before beginning Cialis treatment. 

Some benefits of taking Cialis include:

• ED symptom improvement
• May avoid surgery
• Low-dosage
• Easier urination
• Increased quality of life

Some men may experience medication-related symptoms, including:

• Nausea
• Headaches
• Muscle pain
• Facial flushing

It’s always best to discuss side effects with a doctor, as they may be able to find ways to mitigate them.

The Best Treatment for Enlarged Prostate Can Vary

In the course of finding the best BPH treatment, doctors assess every man on a case-by-case basis. Many may prefer watchful waiting or medications, as they have a reduced risk of lasting side effects. However, surgery is sometimes necessary when neither option works.

When exploring treatments, it’s important to weigh all the risks and benefits with your provider.

eDrugstore Can Help

Finding the right approach for treating BPH can feel overwhelming. In some cases, surgery may result in lasting effects that worsen LUTS and ED. At eDrugstore, we provide FDA-approved medications that can reduce the symptoms associated with BPH and postsurgical BPH side effects.

Following a consultation with a licensed U.S. doctor, you may find that Cialis is a viable option for you. When you order with eDrugstore, your medication will be shipped quickly and discreetly, and virtual health visits and shipping are always free.