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http://atoz.iqhealth.com/Atoz/Bph/bphtreatment.htmlNEW TREATMENTS FOR BENIGN PROSTATIC HYPERPLASIA

New treatments are constantly being developed for benign prostatic hyperplasia (BPH). Hereare some of the latest developments.

Thermotherapy

The traditional transurethal resection of the prostate (TURP) uses an electrically heated "hotknife" to core out the prostate. The following new treatments all use some form of heat

(thermotherapy) to destroy prostate tissue. All of these are proprietary, which means a singlecompany has patented, developed, manufactured and gained government approval to market

and use them.

The Urologix Targis system is a proprietary microwave device that uses the same heatingmethod as a microwave oven. The procedure takes about an hour and requires absolutely noanesthesia (numbing). All the doctor does is insert a special flexible tube into the penis. Thistube contains a unique microwave antenna that is able to generate very localized hot spotswhile cooling the surrounding areas. Diseased prostate tissue is destroyed with very little

discomfort and a short recovery time. To this date, men who have had this procedure are stillfree of symptoms after three years, and it has yet to produce any long-term complications

such as impotence or incontinence.

The Dornier MedTech's Urowave is another proprietary microwave heating device, similar

to the Targis System.

The Prostatron, manufactured by EDAP Technomed Inc., also uses microwave energy,which it calls Trans Urethral Microwave Thermotherapy (TUMT), to destroy overgrownprostate tissue. This instrument is housed in a trailer and transported from one hospital to

another. The procedure takes about an hour, requires only local anesthesia, and has the samelow rate of complications as the other new technologies. Microwave therapy, when compared

to the standard TURP, has proven to have a similar effect in relieving symptoms of BPH.Microwave therapy has been associated with serious thermal injuries when not performed

properly. With any new technology, there is a learning curve. Be sure to ascertain yoursurgeon's level of experience with this new procedure.

Interstitial laser coagulation introduces a laser into the urethra using a small cystoscope.The laser heats prostate tissue, destroying it during a 30- to 60-minute outpatient procedure.

Several studies have shown laser prostatectomy to be as effective as TURP in relievingsymptoms of BPH. Longer term follow up will be necessary to establish whether an operation is

needed with laser prostatectomoy secondary to recurrence of BPH symptoms.

Aromatase -- inhibiting drugs to suppress excess levels of estrogen in the blood are currentlybeing investigated. In many men, estrogen is the primary growth-stimulating agent thatcauses prostatic overgrowth.

Prostatic stents are wire devices shaped like small springs or coils. Stents are placed within

the prostate channel and are used to keep the channel open. Long-term evidence is limited.But in one study that used stents, bladder stones complicated the treatment in some patients.

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Points to remember

If you and your hormones live long enough, you will probably get BPH.

Get your prostate checked every year. BPH is usually harmless, but prostate cancer

isn't.

Follow the decline in your urine flow so that your urologist can properly advise you of

treatment options.

Keep informed. New treatments are appearing all the time.

Want to learn more about BPH? Then check out these articles.Benign Prostatic HyperplasiaTraditional Treatments for BPH

This article was reviewed April 2004, by Dennis C. Policastro, M.D., FACP, FACEP, ResidencyProgram Director, Internal Medicine, Pennsylvania Hospital, University of Pennsylvania,

Philadelphia, PA.

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