Topic: Prostate Enlargement: Benign Prostatic Hyperplasia
Question: What are the treatments for Prostate Enlargement: Benign Prostatic Hyperplasia ?
Answer: The complications of benign prostatic hyperplasia treatment depend on the type of treatment.
                
Medications
                
Medications used to treat benign prostatic hyperplasia may have side effects that sometimes can be serious. Men who are prescribed medications to treat benign prostatic hyperplasia should discuss possible side effects with a health care provider before taking the medications. Men who experience the following side effects should contact a health care provider right away or get emergency medical care:
                
- hives  - rash  - itching  - shortness of breath  - rapid, pounding, or irregular heartbeat  - painful erection of the penis that lasts for hours  - swelling of the eyes, face, tongue, lips, throat, arms, hands, feet, ankles, or lower legs  - difficulty breathing or swallowing  - chest pain  - dizziness or fainting when standing up suddenly  - sudden decrease or loss of vision  - blurred vision  - sudden decrease or loss of hearing  - chest pain, dizziness, or nausea during sexual activity
                
These side effects are mostly related to phosphodiesterase-5 inhibitors. Side effects related to alpha blockers include
                
- dizziness or fainting when standing up suddenly  - decreased sexual drive  - problems with ejaculation
                
Minimally Invasive Procedures
                
Complications after minimally invasive procedures may include
                
- UTIs  - painful urination  - difficulty urinating  - an urgent or a frequent need to urinate  - urinary incontinence  - blood in the urine for several days after the procedure  - sexual dysfunction  - chronic prostatitislong-lasting inflammation of the prostate  - recurring problems such as urinary retention and UTIs
                
Most of the complications of minimally invasive procedures go away within a few days or weeks. Minimally invasive procedures are less likely to have complications than surgery.
                
Surgery
                
Complications after surgery may include
                
- problems urinating  - urinary incontinence  - bleeding and blood clots  - infection  - scar tissue  - sexual dysfunction  - recurring problems such as urinary retention and UTIs
                
Problems urinating. Men may initially have painful urination or difficulty urinating. They may experience urinary frequency, urgency, or retention. These problems will gradually lessen and, after a couple of months, urination will be easier and less frequent.
                
Urinary incontinence. As the bladder returns to normal, men may have some temporary problems controlling urination. However, long-term urinary incontinence rarely occurs. The longer urinary problems existed before surgery, the longer it takes for the bladder to regain its full function after surgery.
                
Bleeding and blood clots. After benign prostatic hyperplasia surgery, the prostate or tissues around it may bleed. Blood or blood clots may appear in urine. Some bleeding is normal and should clear up within several days. However, men should contact a health care provider right away if
                
- they experience pain or discomfort  - their urine contains large clots  - their urine is so red it is difficult to see through
                
Blood clots from benign prostatic hyperplasia surgery can pass into the bloodstream and lodge in other parts of the bodymost often the legs. Men should contact a health care provider right away if they experience swelling or discomfort in their legs.
                
Infection. Use of a Foley catheter after benign prostatic hyperplasia surgery may increase the risk of a UTI. Anesthesia during surgery may cause urinary retention and also increase the risk of a UTI. In addition, the incision site of an open prostatectomy may become infected. A health care provider will prescribe antibiotics to treat infections.
                
Scar tissue. In the year after the original surgery, scar tissue sometimes forms and requires surgical treatment. Scar tissue may form in the urethra and cause it to narrow. A urologist can solve this problem during an office visit by stretching the urethra. Rarely, the opening of the bladder becomes scarred and shrinks, causing blockage. This problem may require a surgical procedure similar to TUIP.
                
Sexual dysfunction. Some men may experience temporary problems with sexual function after benign prostatic hyperplasia surgery. The length of time for restored sexual function depends on the type of benign prostatic hyperplasia surgery performed and how long symptoms were present before surgery. Many men have found that concerns about sexual function can interfere with sex as much as the benign prostatic hyperplasia surgery itself. Understanding the surgical procedure and talking about concerns with a health care provider before surgery often help men regain sexual function earlier. Many men find it helpful to talk with a counselor during the adjustment period after surgery. Even though it can take a while for sexual function to fully return, with time, most men can enjoy sex again.
                
Most health care providers agree that if men with benign prostatic hyperplasia were able to maintain an erection before surgery, they will probably be able to have erections afterward. Surgery rarely causes a loss of erectile function. However, benign prostatic hyperplasia surgery most often cannot restore function that was lost before the procedure. Some men find a slight difference in the quality of orgasm after surgery. However, most report no difference.
                
Prostate surgery may make men sterile, or unable to father children, by causing retrograde ejaculationthe backward flow of semen into the bladder. Men flush the semen out of the bladder when they urinate. In some cases, medications such as pseudoephedrine, found in many cold medications, or imipramine can treat retrograde ejaculation. These medications improve muscle tone at the bladder neck and keep semen from entering the bladder.
                
Recurring problems. Men may require further treatment if prostate problems, including benign prostatic hyperplasia, return. Problems may arise when treatments for benign prostatic hyperplasia leave a good part of the prostate intact. About 10 percent of men treated with TURP or TUIP require additional surgery within 5 years. About 2 percent of men who have an open prostatectomy require additional surgery within 5 years.2
                
In the years after benign prostatic hyperplasia surgery or treatment, men should continue having a digital rectal exam once a year and have any symptoms checked by a health care provider. In some cases, the health care provider may recommend a digital rectal exam and checkup more than once a year.
(Source: NIDDK)