Written by Mr Richard Hindley for Doctify
So, what actually is Benign Prostate Hyper Plasia (BHP)?
Benign Prostate Hyperplasia, or BPH is the enlargement of the prostate, which has an impact on urinary function as we get older.
This condition affects adult men, and is one of the most common diseases affecting men over 50. A huge issue surrounding treatment of this condition is the treatment’s effects on sexual performance. Often men are initially given medication to help with their symptoms only to find that a few years later the medication no longer works and they are faced with daunting decisions about which operation to select.
What is the traditional treatment?
- Medication, which can have undesirable side effects, including erectile dysfunction and dizziness
- TURP (transurethral resection of prostate), which is completed under general aesthetic. This involves a metal loop being inserted through the urethra to scrape it out, freeing up the flow. This can lead to Retrograde Ejaculation, which is when a man cannot ejaculate during sex. Retrograde Ejaculation is the most common long-term complication of TURP and can occur in as many as 90% of cases. Other procedures such as Greenlight laser and Holmium laser prostate surgery are arguably better alternatives but the risks (albeit slightly less) are still there
As you can imagine, neither of these are ideal. Although the urinary symptoms will improve, there is a risk that sexual function will suffer.
Are there any other options?
There is now a new procedure called Rezum. This is a minimally invasive procedure that can be done under LA/sedation in about 15 mins for men with BPH. You can go home the same day.
Rezum is ideal for younger men who have LUTS (lower urinary tract symptoms) when medications aren’t working. Either that, or you don’t like the side effects (such as erectile dysfunction) of the tablets, or simply don’t wish to take any medication.
This treatment will not upset the sexual side of things. It’s also a good alternative if patients don’t want to have an invasive surgical procedure. That, and the complications of dry ejaculation and reduced erectile function that are associated with mainstream surgery.
It’s also suitable for older men, who find medication ineffectual and may not be fit enough for a TURP, which is a bigger operation.
A little more about Rezum
- The FDA approved Rezum in 2015
- 10,000 Rezum procedures have been performed worldwide – mainly in the USA.
- Doctify Urologist Dr Richard Hindley is the first surgeon to offer the treatment in the UK. He has done about 13 so far at Basingstoke Hospital, with lots more booked in. The results so far have been great.
- Although the improvement in symptoms may not be as profound as with TURP most men are happy to have a minimally invasive treatment such as Rezum given the favourable side effect profile – even if there is a greater likelihood that the treatment may need to be repeated at a later date.
